Active NPI
Penny J Huerta, CCC-SLP
- Speech-Language Pathologist
- Tucumcari, NM
National Provider Identifier
1679626626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3903
- Practice address
- 2400 S 8TH St
Tucumcari, NM 88401-3726 - Phone
- (505) 461-4344
- NPI assigned
- Jan 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3903 | NM | Primary |
Addresses
Primary practice location
2400 S 8TH St
Tucumcari, NM 88401-3726
Mailing address
144 Wilmington Cir
Clovis, NM 88101-9311
Phone (505) 762-7333
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3903 | Other | NM | STATE SLP LICENSE |
| 02427575 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3903 | NM | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tucumcari Public Schools | 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 and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Tucumcari, NM
- NPI 1659471456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679626626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 WILMINGTON CIR",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881019311",
"telephone_number": "505-762-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 S 8TH ST",
"city": "TUCUMCARI",
"state": "NM",
"postal_code": "884013726",
"telephone_number": "505-461-4344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUERTA",
"first_name": "PENNY",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "3903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE SLP LICENSE",
"identifier": "3903",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02427575",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucumcari, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.