Blue Heron Speech Therapy, PLLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

BLUE HERON SPEECH THERAPY, PLLC

Practice address

1207 Cherokee St
Pascagoula, MS 39581-2403

Phone

(251) 521-1389

NPI assigned

Jul 2, 2026

Last updated

Jul 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kendall Davis, SLPNPI 1134085459

Title

Speech Pathologist

Phone

(228) 224-9359

Specialties & licenses 1

Addresses

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.

• Kendall Davis, SLP

  • Speech-Language Pathologist
  • Pascagoula, MS
  • NPI 1134085459
  NPD (past) Authorized official

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

{
    "created_epoch": "1782950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1962329789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 CHEROKEE ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395812403",
            "telephone_number": "251-521-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 CHEROKEE ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395812403",
            "telephone_number": "251-521-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HERON SPEECH THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "228-224-9359",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Sue Bilbo, APRN-BC-ANP-C
• Kayla Julaine Bird, DO
• Arthur Dewayne Black, MD
• Emilia Blackwell, OT
• Demari Blakely
• Raymond Patrick Blythe, CFNP
• Erin Hakim Bohner
• Katherine Harlan Bolding, DDS
• Hannah Olivia Booker
• Ada Ruth Bosarge, PT CMDT

• Rehabilitation Clinic/Center in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Rehabilitation Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.