Individual provider Active NPI

Edward B. Herzig, M.D.

  • Rheumatology Physician
  • Fairfield, OH
National Provider Identifier
1073573218
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
35038198 Issued in OH
Practice address
5150 Sandy LN
Fairfield, OH 45014-2738
Phone
(513) 896-9595
Fax
(513) 896-4171
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 35038198 OH Primary

Addresses

Primary practice location

5150 Sandy LN
Fairfield, OH 45014-2738

Mailing address

5150 Sandy LN
Fairfield, OH 45014-2738
Phone (513) 896-9595

Other identifiers 2

IdentifierTypeStateIssuer
P00824188OtherOHMEDICARE RR
0377159MedicaidOH

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

LicenseStateTypeSpecialty
35038198OHMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1073573218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SANDY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "telephone_number": "513-896-9595",
            "fax_number": "513-896-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 SANDY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "telephone_number": "513-896-9595",
            "fax_number": "513-896-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZIG",
        "first_name": "EDWARD",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "35038198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00824188",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0377159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.