Individual provider Active NPI

Kara Heckerman

  • Speech-Language Pathologist
  • Daytona Beach, FL
National Provider Identifier
1750639852
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14772 Issued in FL
Practice address
1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone
(386) 255-4568
Fax
(386) 258-7677
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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 14772 FL Primary

Addresses

Primary practice location

1219 Dunn Ave
Daytona Beach, FL 32114-2405

Mailing address

1219 Dunn Ave
Daytona Beach, FL 32114-2405

Other names 1

  • Kara Heckerman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325002880 FL Practitioner - Qualified Speech Language Pathologist 0143667212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14772FLMDPhysical Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1750639852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-255-4568",
            "fax_number": "386-258-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKERMAN",
        "first_name": "KARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "14772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARA",
            "last_name": "HECKERMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.