Active NPI
Jennifer R Herrell, M.D.
- Internal Medicine Physician
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01062489A
- Practice address
- 3700 Washington Ave
Evansville, IN 47750-0001 - Phone
- (812) 485-7040
- Fax
- (812) 485-7042
- NPI assigned
- Aug 30, 2006
- Last updated
- Jan 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01062489A | IN | Primary |
Addresses
Primary practice location
3700 Washington Ave
Evansville, IN 47750-0001
Mailing address
3700 Washington Ave
Evansville, IN 47714-0541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200853140 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3500 Good Samaritan Way
Louisville, KY 40299-6117
Phone (502) 267-7403
514 16TH St
Bedford, IN 47421-3817
Phone (248) 660-1220
816 N 1St Ave
Evansville, IN 47710-1938
Phone (812) 426-2841
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complexcare Medical Group Midwest M PLLC | Internal Medicine | Current | Accepting new patients |
| Theoria Medical | Internal Medicine | Current | Accepting new patients |
| Owensboro Ky Opco LLC | Past | Accepting new patients |
Locations
514 16th St
Bedford, IN 47421
Phone (812) 279-2001
155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437
501 S Murphy Ave
Brazil, IN 47834
Phone (812) 442-0403
816 N 1st Ave
Evansville, IN 47710
Phone (812) 426-2841
2905 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5491
309 W Pike Ave
Petersburg, IN 47567
Phone (812) 354-8833
251 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-6158
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
Organizations & group practices 4
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.
-
- Mental Health Counselor
- Louisville, KY
- NPI 1629600879
-
dba Chautauqua Health and Rehabilitation
- Skilled Nursing Facility
- Owensboro, KY
- NPI 1073189734
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba The Women's Hospital
- General Acute Care Hospital
- Newburgh, IN
- NPI 1780535427
-
- General Acute Care Hospital
- Evansville, IN
- NPI 1053361642
-
dba Brickyard Healthcare - Woodbridge Care Center
- Skilled Nursing Facility
- Evansville, IN
- NPI 1124070347
Nursing home
-
dba Chautauqua Health and Rehabilitation
- Skilled Nursing Facility
- Owensboro, KY
- NPI 1073189734
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1063521441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477500001",
"telephone_number": "812-485-7040",
"fax_number": "812-485-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRELL",
"first_name": "JENNIFER",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01062489A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200853140",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.