Active NPI
Amy Marie Hanzevack, SLP
- Speech-Language Pathologist
- Forest Hill, MD
National Provider Identifier
1982830733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 05564
- Practice address
- 22 Newport Dr
Forest Hill, MD 21050-1642 - Phone
- (443) 752-1617
- Fax
- (410) 727-5186
- NPI assigned
- Jun 8, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 05564 | MD | Primary |
Addresses
Primary practice location
22 Newport Dr
Forest Hill, MD 21050-1642
Mailing address
402 Poplar Grove PL
Bel Air, MD 21014-2768
Phone (443) 752-1617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05564 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244419200000",
"number": "1982830733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 POPLAR GROVE PL",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210142768",
"telephone_number": "443-752-1617",
"fax_number": "410-727-5186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 NEWPORT DR",
"city": "FOREST HILL",
"state": "MD",
"postal_code": "210501642",
"telephone_number": "443-752-1617",
"fax_number": "410-727-5186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANZEVACK",
"first_name": "AMY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-08",
"last_updated": "2009-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "05564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.