Individual provider Active NPI

Carlton Wayne Herald, DO

  • Internal Medicine Physician
  • Gallipolis, OH
National Provider Identifier
1053302836
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.007166 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(740) 446-5533
Fax
(740) 441-3318
NPI assigned
Nov 2, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.007166 OH
Internal Medicine Physician 207R00000X 1984 WV
Internal Medicine Physician 207R00000X 34.007166 OH Primary

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

PO Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396

Other practice location 1

#3 Adena Drive
Kermit, WV 25674
Phone (304) 393-4090

Other identifiers 4

IdentifierTypeStateIssuer
2005609000MedicaidWV
2168890MedicaidOH
00427029OtherWVRR MEDICARE
64071467MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040106000285 WV Practitioner - Internal Medicine 9739087867 Reassigns benefits to 2 organizations
I20130424000315 OH Practitioner - Internal Medicine 9739087867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

500 Burlington Rd
Jackson, OH 45640-9360
Phone (740) 395-8420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1984WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince May 30, 2013 Accepting new patients
Holzer Clinic, LLC CurrentSince Aug 5, 2016 Accepting new patients
Ohiohealth Corporation Internal Medicine CurrentSince May 30, 2013 Accepting new patients
Apogee Medical Group, West Virginia, PLLC CurrentSince Jul 22, 2014 Accepting new patients
Health Care Alliance, Inc. Emergency Medicine CurrentSince Jan 18, 2014 Accepting new patients
I Path LLC Current Accepting new patients
Consolidated Medical Specialists, Inc. Internal Medicine Past Accepting new patients
Associates in Gastroenterology and Hepatology, Inc. Internal Medicine Past Accepting new patients
Elm Emergency Group PLLC Emergency Medicine Past Accepting new patients
Holzer Hospital Foundation Past Accepting new patients

Locations

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

500 Burlington Rd
Jackson, OH 45640
Phone (740) 288-4625

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053302836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5533",
            "fax_number": "740-441-3318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "#3 Adena Drive",
            "address_purpose": "LOCATION",
            "city": "Kermit",
            "state": "WV",
            "postal_code": "25674",
            "country_code": "US",
            "telephone_number": "304-393-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERALD",
        "first_name": "CARLTON",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.007166",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "1984",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.007166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005609000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2168890",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "00427029",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64071467",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.