Organization Active NPI

Stephen M Herman MD, LLC

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1154791994
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STEPHEN M HERMAN MD, LLC
Practice address
130 Tibet Ave
Suite 206
Savannah, GA 31406-9028
Phone
(912) 777-8454
Fax
(912) 525-3212
NPI assigned
Oct 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Dr. Stephen M Herman, MD
Title
Owner
Phone
(912) 777-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X GA Primary

Addresses

Primary practice location

130 Tibet Ave
Suite 206
Savannah, GA 31406-9028

Mailing address

130 Tibet Ave
Suite 206
Savannah, GA 31406-9028
Phone (912) 777-8454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151008002573 GA Part B Supplier - Clinic/Group Practice 1658689773 Receives reassigned benefits from 1 practitioner
Practice locations: Savannah, GA

National Provider Directory

National Provider Directory

Locations

130 Tibet Ave
Apt 206
Savannah, GA 31406
Phone (912) 777-8454

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1154791994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TIBET AVE",
            "address_2": "SUITE 206",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314069028",
            "telephone_number": "912-777-8454",
            "fax_number": "912-525-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 TIBET AVE",
            "address_2": "SUITE 206",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314069028",
            "telephone_number": "912-777-8454",
            "fax_number": "912-525-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M HERMAN MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-777-8454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.

Verify at the official NPI Registry.