Cory Herzog, DNP,CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

1130963 Issued in TX

Practice address

701 McClintic Dr
Groesbeck, TX 76642-2128

Phone

(254) 729-3281

NPI assigned

Jul 10, 2019

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Limestone Hospital District

  dba Limestone Medical Center

  • Critical Access Hospital
  • Groesbeck, TX
  • NPI 1861487779

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1003468190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MCCLINTIC DR",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766422128",
            "telephone_number": "254-729-3281",
            "fax_number": "254-729-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MCCLINTIC DR",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766422128",
            "telephone_number": "254-729-3281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3495 Bailey Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142151129",
            "country_code": "US",
            "telephone_number": "716-834-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "CORY",
        "credential": "DNP,CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1130963",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "647231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Ann Hackbarth, FNP
• Hampton's Assisted Living Home
• Haleigh Paige Harris, OTD, OTR
• Heart of Texas Region Mental Health Mental Retardation Center
• Heart of Texas Region Mental Health Mental Retardation Center
• Erin Holland, APRN
• Larry C Hughes, D.O.
• Faythe Hutson
• Christian Paul Jacobsen, MD
• Jeffrey D Rettig DO PA (Rettig Family Health Care)

• Certified Registered Nurse Anesthetist in Groesbeck, TX
• Providers in Groesbeck, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.