Individual provider Active NPI

Jessica Herring, PT, DPT, ATC

  • Pediatric Rehabilitation Medicine Physician
  • Annapolis, MD
National Provider Identifier
1124709266
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
29511 Issued in MD
Practice address
1911 Lincoln Dr
Annapolis, MD 21401-4118
Phone
(410) 573-1064
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X 29511 MD Primary

Addresses

Primary practice location

1911 Lincoln Dr
Annapolis, MD 21401-4118

Mailing address

1911 Lincoln Dr
Annapolis, MD 21401-4118
Phone (410) 573-1064

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29511MDMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Children's Therapy Center LLC Current Accepting new patients
Annapolis Children's Therapy Center LLC Current Accepting new patients

Locations

1911 Lincoln Dr
Annapolis, MD 21401
Phone (410) 572-1064

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1124709266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 LINCOLN DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014118",
            "telephone_number": "410-573-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 LINCOLN DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014118",
            "telephone_number": "410-573-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRING",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "MD",
            "license": "29511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.