Individual provider Active NPI

Katarzyna Maria Herdman

  • Other Specialist/Technologist
  • Acworth, GA
National Provider Identifier
1396540571
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Practice address
3335 Cobb Pkwy NW Ste 404
Acworth, GA 30101-8362
Phone
(724) 422-7109
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Z00000X Primary

Addresses

Primary practice location

3335 Cobb Pkwy NW Ste 404
Acworth, GA 30101-8362

Mailing address

2280 Mantilla CT NW
Acworth, GA 30101-4590
Phone (724) 422-7109

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

NPI Registry JSON

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1396540571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MANTILLA CT NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014590",
            "telephone_number": "724-422-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 COBB PKWY NW STE 404",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018362",
            "telephone_number": "724-422-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDMAN",
        "first_name": "KATARZYNA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.