NPIMap

Organization Active NPI

Herboth Developmental Therapy

  • Developmental Therapist
  • Altamont, IL
National Provider Identifier
1851950414
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
HERBOTH DEVELOPMENTAL THERAPY
Practice address
2868 E 825TH Ave
Altamont, IL 62411-3554
Phone
(618) 322-5493
Fax
(217) 280-4261
NPI assigned
Jun 7, 2019
Last updated
Jun 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelly HerbothNPI 1386941292
Title
Owner
Phone
(618) 322-5493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU
Developmental Therapist 222Q00000X NU Primary

Addresses

Primary practice location

2868 E 825TH Ave
Altamont, IL 62411-3554

Mailing address

2868 E 825TH Ave
Altamont, IL 62411-3554
Phone (618) 322-5493

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Altamont

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1851950414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2868 E 825TH AVE",
            "city": "ALTAMONT",
            "state": "IL",
            "postal_code": "624113554",
            "telephone_number": "618-322-5493",
            "fax_number": "217-280-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 E 825TH AVE",
            "city": "ALTAMONT",
            "state": "IL",
            "postal_code": "624113554",
            "telephone_number": "618-322-5493",
            "fax_number": "217-280-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERBOTH DEVELOPMENTAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "HERBOTH",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-322-5493"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Altamont",
            "affiliation": "N",
            "address_1": "2868 E 825th Ave",
            "city": "Altamont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624113554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altamont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.