Individual provider Active NPI

Robyn M Hershberger, SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1528280161
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA12708 Issued in FL
Practice address
807 Childrens Way
Jacksonville, FL 32207
Phone
(910) 298-6207
Fax
(910) 298-6293
NPI assigned
May 3, 2007
Last updated
Feb 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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 120265516 NC
Speech-Language Pathologist 235Z00000X SA12708 FL Primary

Addresses

Primary practice location

807 Childrens Way
Jacksonville, FL 32207

Mailing address

10140 Centurion Parkway North
Jacksonville, FL 32256-0532
Phone (904) 697-4201

Other practice location 1

191 North NC Hwy 41
Beulaville, NC 28518
Phone (910) 298-6207

Other identifiers 2

IdentifierTypeStateIssuer
014831100MedicaidFL
NAOtherNCAPPLYING FOR

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
SA12708FLMDSpeech-Language Pathologist
120265516NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation 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, 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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1528280161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PARKWAY NORTH",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4201",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "910-298-6207",
            "fax_number": "910-298-6293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 North NC Hwy 41",
            "address_purpose": "LOCATION",
            "city": "Beulaville",
            "state": "NC",
            "postal_code": "28518",
            "country_code": "US",
            "telephone_number": "910-298-6207",
            "fax_number": "910-298-6293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERSHBERGER",
        "first_name": "ROBYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "120265516",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014831100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLYING FOR",
            "identifier": "NA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.