Katie Elizabeth Hern, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2010013487 Issued in MO

Practice address

1605 Martin Springs Dr
Ste 230
Rolla, MO 65401-2931

Phone

(573) 458-6350

Fax

(573) 458-6764

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1093936585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "STE 230",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6350",
            "fax_number": "573-458-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERN",
        "first_name": "KATIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010013487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01094294",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093936585",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Henderson
• Brandy Hendricks, RN
• Henry J Antolak DMD PC
• Heritage Park Skilled Care
• Kristi Leigh Heritage, MA,LPC
• Holly Herndon, RN
• Gretchen M Hessler, MA
• Lois Katherine Gornet Hilgers, MHS RDN LD LNHA
• Michelle M Hill, DO
• Shirley Mae Hitt, FNP

• Family Medicine Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.