Individual provider Active NPI

Kelley Hebert

  • Speech-Language Pathologist
  • Metairie, LA
National Provider Identifier
1407109911
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3392 Issued in LA
Practice address
2901 Ridgelake Dr
Suite 107
Metairie, LA 70002-4966
Phone
(504) 309-0868
Fax
(504) 309-0867
NPI assigned
Oct 22, 2012
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 3392 LA Primary

Addresses

Primary practice location

2901 Ridgelake Dr
Suite 107
Metairie, LA 70002-4966

Mailing address

2901 Ridgelake Dr
Suite 107
Metairie, LA 70002-4966
Phone (504) 309-0868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410001051 LA Practitioner - Qualified Speech Language Pathologist 8628416609 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Feb 28, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Feb 28, 2024 Accepting new patients
Southern Flex Rehabilitation & Consulting, LLC Speech-Language Pathologist Past Accepting new patients
Southern Flex Rehabilitation and Consulting, LLC Speech-Language Pathologist PastSince Jan 1, 2017 Accepting new patients

Locations

270 Ashton Plantation Blvd
Luling, LA 70070
Phone (985) 236-1345

3732 W Esplanade Ave S
Metairie, LA 70002
Phone (504) 318-0380

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

900 Johnson St
Tallulah, LA 71282
Phone (318) 395-2241

Organizations & group practices 4

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": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1407109911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 RIDGELAKE DR",
            "address_2": "SUITE 107",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024966",
            "telephone_number": "504-309-0868",
            "fax_number": "504-309-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 RIDGELAKE DR",
            "address_2": "SUITE 107",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024966",
            "telephone_number": "504-309-0868",
            "fax_number": "504-309-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "3392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.