Active NPI
Marisa Herrera
- Speech-Language Pathologist
- Santa Teresa, NM
National Provider Identifier
1770869067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4721
- Practice address
- 4950 McNutt Rd
Santa Teresa, NM 88008-9621 - Phone
- (575) 882-6200
- NPI assigned
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 4721 | NM | Primary |
Addresses
Primary practice location
4950 McNutt Rd
Santa Teresa, NM 88008-9621
Mailing address
4950 McNutt Rd
Santa Teresa, NM 88008-9621
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 |
|---|---|---|---|
| 4721 | NM | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1770869067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4950 MCNUTT RD",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "880089621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4950 MCNUTT RD",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "880089621",
"telephone_number": "575-882-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRERA",
"first_name": "MARISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "4721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Teresa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.