Individual provider Active NPI

Gail A Sochacky-Herbert

  • Speech-Language Pathologist
  • Panama City, FL
National Provider Identifier
1124154778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA5633 Issued in FL
Practice address
2195 Jenks Ave Ste a
Panama City, FL 32405-4551
Phone
(850) 522-4770
Fax
(850) 769-2366
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SA5633 FL Primary

Addresses

Primary practice location

2195 Jenks Ave Ste a
Panama City, FL 32405-4551

Mailing address

2195 Jenks Ave Ste a
Panama City, FL 32405-4551
Phone (850) 522-4770

Other identifiers 1

IdentifierTypeStateIssuer
20-2945722OtherFLADVANCE REHAB TAX ID

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
SA5633FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehab & Home Health LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124154778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE A",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054551",
            "telephone_number": "850-522-4770",
            "fax_number": "850-769-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE A",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054551",
            "telephone_number": "850-522-4770",
            "fax_number": "850-769-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCHACKY-HERBERT",
        "first_name": "GAIL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE REHAB TAX ID",
            "identifier": "20-2945722",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.