Individual provider Active NPI

Heather Berner

  • Speech-Language Pathologist
  • Hollywood, FL
National Provider Identifier
1174914071
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 13770 Issued in FL
Practice address
4460 Casper CT
Hollywood, FL 33021-2416
Phone
(954) 483-7859
NPI assigned
Feb 12, 2015
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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 07311 MD
Speech-Language Pathologist 235Z00000X SA 13770 FL Primary

Addresses

Primary practice location

4460 Casper CT
Hollywood, FL 33021-2416

Mailing address

4460 Casper CT
Hollywood, FL 33021-2416
Phone (954) 483-7859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603002860 FL Practitioner - Qualified Speech Language Pathologist 9830422062 Reassigns benefits to 2 organizations
Practice locations: Hollywood, FL

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supreme Speech Therapy IncGroup PAC ID 0345762746, 4 clinicians
Leverage Health IncGroup PAC ID 4688860513, 32 clinicians

Practice addresses (Care Compare)

Hollywood, FL 33021
Phone (954) 483-7859

2655 E Oakland Park Blvd
Suite 5
Fort Lauderdale, FL 33306-1608
Phone (954) 630-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07311MDMDOccupational Therapist
SA 13770FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Supreme Speech Therapy Inc Speech-Language Pathologist CurrentSince Jan 6, 2025 Accepting new patients
Leverage Health, Inc. CurrentSince Apr 17, 2019 Accepting new patients

Locations

2655 E Oakland Park Blvd
Ste 5
Oakland Park, FL 33306
Phone (954) 630-3131

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1174914071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 CASPER CT",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212416",
            "telephone_number": "954-483-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 CASPER CT",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212416",
            "telephone_number": "954-483-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNER",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "07311",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 13770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.