Active NPI
Andrea J Herman, SPEECH PATHOLOGIST
- Speech-Language Pathologist
- Waterloo, IA
National Provider Identifier
1285605485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01256
- Practice address
- 815 W Tower Park Dr
Waterloo, IA 50701-9026 - Phone
- (319) 233-6995
- Fax
- (319) 233-7083
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01256 | IA | Primary |
Addresses
Primary practice location
815 W Tower Park Dr
Waterloo, IA 50701-9026
Mailing address
850 43Rd Ave
Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01256 | Other | IA | IOWA LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01256 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Valley Physical Therapy Center | Speech-Language Pathologist | 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.
-
- Physical Therapist
- Moline, IL
- NPI 1245373166
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334102400000",
"number": "1285605485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE",
"address_2": "STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 W TOWER PARK DR",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507019026",
"telephone_number": "319-233-6995",
"fax_number": "319-233-7083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "ANDREA",
"middle_name": "J",
"credential": "SPEECH PATHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2012-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "01256",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA LICENSE",
"identifier": "01256",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.