Active NPI
Herschell Servies Jr., M.D.
- Infectious Disease Physician
- Lebanon, IN
National Provider Identifier
1013904671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 01026360
- Practice address
- 2705 N Lebanon St Ste 150
Lebanon, IN 46052-8622 - Phone
- (765) 485-8880
- Fax
- (765) 485-8889
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 01026360 | IN | |
| Infectious Disease Physician | 207RI0200X | 01026360 | IN | Primary |
Addresses
Primary practice location
2705 N Lebanon St Ste 150
Lebanon, IN 46052-8622
Mailing address
2705 N Lebanon St Ste 305
Lebanon, IN 46052-8622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100191250 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | herschell.servies@whs.eclinicaldirectplus.com | Health Information Exchange (HIE) | Witham Memorial Hospital |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01026360 | IN | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1013904671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 N LEBANON ST STE 305",
"city": "LEBANON",
"state": "IN",
"postal_code": "460528622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 N LEBANON ST STE 150",
"city": "LEBANON",
"state": "IN",
"postal_code": "460528622",
"telephone_number": "765-485-8880",
"fax_number": "765-485-8889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERVIES",
"first_name": "HERSCHELL",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IN",
"license": "01026360",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IN",
"license": "01026360",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100191250",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "herschell.servies@whs.eclinicaldirectplus.com",
"affiliation": "Y",
"affiliationName": "Witham Memorial Hospital",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "2705 N Lebanon St Ste 150",
"city": "Lebanon",
"state": "IN",
"country_code": "US",
"postal_code": "460528622",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.