Individual provider Active NPI

Keri Underwood, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Lafayette, LA
National Provider Identifier
1679924690
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5012 Issued in LA
Practice address
103 Villa Park LN
Lafayette, LA 70508-8078
Phone
(337) 277-5541
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 5012 LA Primary

Addresses

Primary practice location

103 Villa Park LN
Lafayette, LA 70508-8078

Mailing address

103 Villa Park LN
Lafayette, LA 70508-8078
Phone (337) 277-5541

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
5012LAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1679924690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 VILLA PARK LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088078",
            "telephone_number": "337-277-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 VILLA PARK LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088078",
            "telephone_number": "337-277-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "KERI",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "5012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.