Individual provider Active NPI

Heidi Jane McRae, CCC-SLP

  • Speech-Language Pathologist
  • Gallatin, TN
National Provider Identifier
1174764930
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0000003608 Issued in TN
Practice address
1018 S Water Ave
Gallatin, TN 37066-3958
Phone
(412) 780-4147
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL009395 PA
Speech-Language Pathologist 235Z00000X 0000003608 TN Primary

Addresses

Primary practice location

1018 S Water Ave
Gallatin, TN 37066-3958

Mailing address

501 Grove Creek Ave
Nashville, TN 37214-4808
Phone (412) 780-4147

Other identifiers 1

IdentifierTypeStateIssuer
1174764930MedicaidPA

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
SL009395PAMDSpeech-Language Pathologist
0000003608TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1174764930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GROVE CREEK AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372144808",
            "telephone_number": "412-780-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 S WATER AVE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663958",
            "telephone_number": "412-780-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "HEIDI",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009395",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000003608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174764930",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.