Individual provider Active NPI

Heather K Anderson, SLP

  • Speech-Language Pathologist
  • Shreveport, LA
National Provider Identifier
1629092986
Registry record updated Nov 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3730 Blair Dr
Lsuhsc-School of Allied Health Professions
Shreveport, LA 71103-4602
Phone
(318) 632-2030
Fax
(318) 675-5666
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2016

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 Primary

Addresses

Primary practice location

3730 Blair Dr
Lsuhsc-School of Allied Health Professions
Shreveport, LA 71103-4602

Mailing address

1501 Kings Hwy
Lsuhsc-Allied Health Clinics
Shreveport, LA 71103-4228
Phone (318) 632-2015

Other identifiers 1

IdentifierTypeStateIssuer
1174173MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222000851 LA Practitioner - Qualified Speech Language Pathologist 4284935917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lsuhsc-S School of Allied HealthGroup PAC ID 0840669123, 23 clinicians

Practice addresses (Care Compare)

1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone (318) 813-2972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3530LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Dec 1, 2016 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

3735 Blair Dr
Shreveport, LA 71103
Phone (318) 632-2015

1450 Claiborne Ave
Shreveport, LA 71103
Phone (318) 813-2970

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480204800000",
    "number": "1629092986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "LSUHSC-ALLIED HEALTH CLINICS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-632-2015",
            "fax_number": "318-675-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 BLAIR DR",
            "address_2": "LSUHSC-SCHOOL OF ALLIED HEALTH PROFESSIONS",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034602",
            "telephone_number": "318-632-2030",
            "fax_number": "318-675-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "HEATHER",
        "middle_name": "K",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174173",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.