Amy Roark Herndon, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3037 Issued in NC

Practice address

6131 Hickory Creek Rd
Winston Salem, NC 27107-3711

Phone

(336) 692-4546

NPI assigned

Jul 17, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1093060956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6131 HICKORY CREEK RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271073711",
            "telephone_number": "336-692-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 HICKORY CREEK RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271073711",
            "telephone_number": "336-692-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "AMY",
        "middle_name": "ROARK",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411149",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Yvonne Hernandez
• Hermes Xavier Hernandez, M.D.
• Lucy Hernandez
• Sean Michael Hernandez, MD
• Sebastian Stone Hernandez, MD
• Julian Bernardo Herrera Acevedo, MD
• Juan Manuel Herrera-Godinez, P.A.
• Julyssa Herrera
• Bradford Herring
• Charles Herring, PHARM.D.

• Speech-Language Pathologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.