Individual provider Active NPI

Kacie L Herrington, M.S. SLP-INTERN

  • Speech-Language Pathologist
  • Tyler, TX
National Provider Identifier
1528547015
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119525 Issued in TX
Practice address
100 E Ferguson St Ste 1204
Tyler, TX 75702-5700
Phone
(877) 688-2520
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 119525 TX Primary
Speech-Language Assistant 2355S0801X 40435 TX

Addresses

Primary practice location

100 E Ferguson St Ste 1204
Tyler, TX 75702-5700

Mailing address

11488 Stuart St
Brownsboro, TX 75756-6107
Phone (254) 978-0430

Other practice location 1

9846 Hwy 31 E
Tyler, TX 75705-2329
Phone (903) 525-8001

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40435TXMDSpeech-Language Assistant
119525TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1528547015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11488 STUART ST",
            "city": "BROWNSBORO",
            "state": "TX",
            "postal_code": "757566107",
            "telephone_number": "254-978-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E FERGUSON ST STE 1204",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025700",
            "telephone_number": "877-688-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9846 Hwy 31 E",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757052329",
            "country_code": "US",
            "telephone_number": "903-525-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "KACIE",
        "middle_name": "L",
        "credential": "M.S. SLP-INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119525",
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "40435",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.