Individual provider Active NPI

Amy Renae Herbert, CCC, SLP

  • Speech-Language Pathologist
  • Ocean Springs, MS
National Provider Identifier
1053705129
Registry record updated Aug 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
6017 Washington Ave
Ocean Springs, MS 39564-2648
Phone
(228) 697-2269
NPI assigned
Mar 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X AL Primary

Addresses

Primary practice location

6017 Washington Ave
Ocean Springs, MS 39564-2648

Mailing address

6017 Washington Ave
Ocean Springs, MS 39564-2648
Phone (228) 697-2269

Other practice location 1

8909 Rand Ave
Daphne, AL 36526-9126
Phone (251) 210-1632

Other identifiers 1

IdentifierTypeStateIssuer
14109551OtherALASHA CERTIFICATION

Other names 1

  • Amy Renae Herbert Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3964ALMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533340800000",
    "number": "1053705129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6017 WASHINGTON AVE",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395642648",
            "telephone_number": "228-697-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6017 WASHINGTON AVE",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395642648",
            "telephone_number": "228-697-2269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8909 Rand Ave",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365269126",
            "country_code": "US",
            "telephone_number": "251-210-1632",
            "fax_number": "251-625-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "AMY",
        "middle_name": "RENAE",
        "credential": "CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2018-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA CERTIFICATION",
            "identifier": "14109551",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HERBERT",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.