Individual provider Active NPI

Anna Elizabeth Herkov, M.A., CCC/SLP

  • Speech-Language Pathologist
  • Gainesville, FL
National Provider Identifier
1295009090
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA630 Issued in FL
Practice address
1313 SW 104TH St
Gainesville, FL 32607-6352
Phone
(352) 327-1214
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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 SA630 FL Primary

Addresses

Primary practice location

1313 SW 104TH St
Gainesville, FL 32607-6352

Mailing address

1313 SW 104TH St
Gainesville, FL 32607-6352
Phone (352) 327-1214

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SA630FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1295009090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 SW 104TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076352",
            "telephone_number": "352-327-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 SW 104TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076352",
            "telephone_number": "352-327-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERKOV",
        "first_name": "ANNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.