Individual provider Active NPI

Amy C Froeba, M.C.D., CCC-SLP

  • Speech-Language Pathologist
  • Kenner, LA
National Provider Identifier
1124153309
Registry record updated Jul 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5594 Issued in LA
Practice address
4305 Indiana Ave
Kenner, LA 70065-2222
Phone
(504) 616-3388
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2014

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 5594 LA Primary

Addresses

Primary practice location

4305 Indiana Ave
Kenner, LA 70065-2222

Mailing address

4305 Indiana Ave
Kenner, LA 70065-2222

Other identifiers 1

IdentifierTypeStateIssuer
1581771MedicaidLA

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

LicenseStateTypeSpecialty
5594LAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1124153309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652222",
            "telephone_number": "504-616-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROEBA",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "M.C.D., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "5594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581771",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2014; 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.