Individual provider Active NPI

Emily Herndon, CCC-SLP

  • Speech-Language Pathologist
  • Waynesville, NC
National Provider Identifier
1407403785
Registry record updated Mar 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30002210 Issued in NC
Practice address
125 Mosa Dr
Waynesville, NC 28786-6832
Phone
(352) 562-3618
Fax
(352) 240-3392
NPI assigned
Aug 21, 2019
Last updated
Mar 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 14256850 FL
Speech-Language Pathologist 235Z00000X 30002210 NC Primary

Addresses

Primary practice location

125 Mosa Dr
Waynesville, NC 28786-6832

Mailing address

125 Mosa Dr
Waynesville, NC 28786-6832
Phone (954) 661-6535

Other names 1

  • Miss Emily Tucker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210621001983 FL Practitioner - Qualified Speech Language Pathologist 5496155392 Reassigns benefits to 2 organizations
I20231204003553 NC Practitioner - Qualified Speech Language Pathologist 5496155392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14256850FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jun 21, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Jun 21, 2021 Accepting new patients
Legacy Healthcare Services, Inc Speech-Language Pathologist CurrentSince Aug 23, 2021 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Aug 23, 2021 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 5

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742688000000",
    "number": "1407403785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MOSA DR",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287866832",
            "telephone_number": "954-661-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MOSA DR",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287866832",
            "telephone_number": "352-562-3618",
            "fax_number": "352-240-3392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "14256850",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "TUCKER",
            "prefix": "MISS",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waynesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2025; 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.