Active NPI
Darrell C Herndon, CRNA
- Certified Registered Nurse Anesthetist
- Birmingham, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1-040120
- Practice address
- 1201 11TH Ave S
Birmingham, AL 35205-3423 - Phone
- (205) 930-7296
- Fax
- (205) 930-7256
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1-040120 | AL | Primary |
Addresses
Primary practice location
1201 11TH Ave S
Birmingham, AL 35205-3423
Mailing address
PO Box 55905
Birmingham, AL 35255-5905
Phone (205) 979-5882
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00729289 | Other | AL | RAILROAD MEDICARE |
| 515-33846 | Other | AL | BC BS OF AL |
| 051557594 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-040120 | AL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Alabama at Birmingham | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| University of Alabama at Birmingham | Current | Accepting new patients | |
| University of Alabama at Birmingham | Current | Accepting new patients | |
| University of Alabama Health Services Foundation, PC. | Current | Accepting new patients | |
| Radiologist @ Uab Highlands | Past | Accepting new patients | |
| Anesthesia Health Care Authority | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
619 19th St S
Birmingham, AL 35249
619 19th St S
Rm JT845
Birmingham, AL 35249
Phone (205) 934-7072
1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100
619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405
Interoperability endpoints
- dherndon@direct.uabmedicine.org
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Montgomery, AL
- NPI 1184738478
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
- Certified Registered Nurse Anesthetist
- Birmingham, AL
- NPI 1356674360
Nurse Anesthetist, Certified Registered
-
- General Acute Care Hospital
- Birmingham, AL
- NPI 1447145818
-
- Certified Registered Nurse Anesthetist
- Birmingham, AL
- NPI 1457317513
Nurse Anesthetist, Certified Registered
-
- Diagnostic Radiology Physician
- Birmingham, AL
- NPI 1700822178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278028800000",
"number": "1104807577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55905",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555905",
"telephone_number": "205-979-5882",
"fax_number": "205-979-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 11TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352053423",
"telephone_number": "205-930-7296",
"fax_number": "205-930-7256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNDON",
"first_name": "DARRELL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2010-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "1-040120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00729289",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF AL",
"identifier": "515-33846",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051557594",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.