NPIMap

Individual provider Active NPI

Andrea Herson

  • Early Intervention Provider Agency
  • Rockville, MD
National Provider Identifier
1376933838
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
00676 Issued in MD
Practice address
11908 Bristol Manor CT
Rockville, MD 20852-5804
Phone
(301) 881-1394
Fax
(240) 260-1450
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 00676 MD Primary

Addresses

Primary practice location

11908 Bristol Manor CT
Rockville, MD 20852-5804

Mailing address

11908 Bristol Manor CT
Rockville, MD 20852-5804
Phone (301) 881-1394

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
00676MDMDEarly Intervention Provider Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Little Sprout Speech, LLC Early Intervention Provider Agency 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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1376933838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11908 BRISTOL MANOR CT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208525804",
            "telephone_number": "301-881-1394",
            "fax_number": "240-260-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11908 BRISTOL MANOR CT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208525804",
            "telephone_number": "301-881-1394",
            "fax_number": "240-260-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSON",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MD",
            "license": "00676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.