Individual provider Active NPI

John Hergenrother, M.D.

  • Nephrology Physician
  • Cincinnati, OH
National Provider Identifier
1073557500
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35-07-5061 Issued in OH
Practice address
2123 Auburn Ave
#404
Cincinnati, OH 45219-2906
Phone
(513) 241-5630
Fax
(513) 241-7146
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35-07-5061 OH Primary
Nephrology Physician 207RN0300X 37649 KY

Addresses

Primary practice location

2123 Auburn Ave
#404
Cincinnati, OH 45219-2906

Mailing address

2123 Auburn Ave
#404
Cincinnati, OH 45219-2906
Phone (513) 241-5630

Other identifiers 3

IdentifierTypeStateIssuer
2330203MedicaidOH
64054018MedicaidKY
390008623OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 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
I20100907000280 OH Practitioner - Nephrology 4688638877 Reassigns benefits to 1 organization
I20111215000767 KY Practitioner - Nephrology 4688638877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Northeastern Ohio University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney and Hypertension Center IncGroup PAC ID 9830099985, 47 clinicians

Practice addresses (Care Compare)

2123 Auburn Ave
Suite 404
Cincinnati, OH 45219-2906
Phone (513) 241-5630

830 Thomas More Pkwy
Suite 202
Edgewood, KY 41017-5103
Phone (859) 341-6281

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37649KYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney and Hypertension Center Inc Nephrology CurrentSince Aug 15, 2002 Accepting new patients
University of Cincinnati Physicians Company, LLC Nephrology PastSince Dec 22, 2013 Accepting new patients

Locations

721 Rudolph Way
Greendale, IN 47025
Phone (812) 537-4240

7370 Turfway Rd
Ste 290
Florence, KY 41042
Phone (330) 637-0348

830 Thomas More Pkwy
Ste 202
Ft Mitchell, KY 41017
Phone (606) 341-6281

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

2123 Auburn Ave
Ste 404
Cincinnati, OH 45219
Phone (513) 241-5630

2123 Auburn Ave
#404
Cincinnati, OH 45219
Phone (513) 241-4983

3219 Clifton Ave
Ste 325
Cincinnati, OH 45220
Phone (513) 861-0800

4600 Montgomery Rd
Ste 105
Cincinnati, OH 45212
Phone (513) 487-5305

Interoperability endpoints

  • Direct secure messaging: johnhergenrother@tkhc.allscriptsdirect.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jhergenrother25648@direct-prd.stelizabeth.com

Organizations & group practices 2

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

Hospital & facility affiliations 11

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1073557500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 AUBURN AVE",
            "address_2": "#404",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-241-5630",
            "fax_number": "513-241-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 AUBURN AVE",
            "address_2": "#404",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-241-5630",
            "fax_number": "513-241-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERGENROTHER",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35-07-5061",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KY",
            "license": "37649",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330203",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64054018",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "390008623",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.