Individual provider Active NPI

Joshua Brent Herndon

  • Internal Medicine Physician
  • Summerville, GA
National Provider Identifier
1194354266
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95722 Issued in GA
Practice address
11766 Highway 27
Summerville, GA 30747-5989
Phone
(706) 857-3915
NPI assigned
Apr 2, 2020
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 95722 GA Primary

Addresses

Primary practice location

11766 Highway 27
Summerville, GA 30747-5989

Mailing address

420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jherndon1252415@CarolinasHealthcareSystem.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719001909 GA Practitioner - Internal Medicine 9133546344 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

11766 Hwy 27
Summerville, GA 30747-5989
Phone (706) 857-3915

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-4340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11866GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Jul 1, 2023 Accepting new patients
Floyd Healthcare Management Inc Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
24 On Physicians, P.C. CurrentSince Oct 1, 2024 Accepting new patients
24 On Physicians, PC CurrentSince Oct 1, 2024 Accepting new patients
Floyd Healthcare Management Inc Past Accepting new patients
Harbin Clinic, LLC PastSince May 1, 2026 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

306 Shorter Ave NW
Rome, GA 30165
Phone (706) 509-3500

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

11766 Highway 27
Summerville, GA 30747
Phone (706) 857-1010

11766 Highway 27
Ste A
Summerville, GA 30747
Phone (706) 230-4240

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

Interoperability endpoints

  • Direct secure messaging: jherndon1252415@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1194354266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE STE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613210",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11766 HIGHWAY 27",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307475989",
            "telephone_number": "706-857-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "JOSHUA",
        "middle_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "95722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jherndon1252415@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "11766 Highway 27",
            "city": "Summerville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307475989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summerville, GA

Sources for this page

Verify at the official NPI Registry.