Bryan Hersch, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0029405 Issued in OH

Practice address

88 MDG
4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529

Phone

(937) 257-6565

Fax

(937) 656-3700

NPI assigned

Sep 4, 2018

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1144702341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MDG",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-6565",
            "fax_number": "937-656-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSCH",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0029405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Anthony Hazlette, CRNA
• Kevin Floyd Heacock, M.D.
• Amber Rose Heller
• Alison Hanna Helmkamp, DO
• Christopher George Herman
• Roger Ronald Hesselbrock, M.D.
• Nicholas David Heuring
• Amy Gammill Hicks, MD
• Marlyna Hidalgo, SOCIAL WORKER
• Eric Andrew High, M.D.

• Family Nurse Practitioner in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.