Active NPI
Stephen Harry Herdman, MD
- Family Medicine Physician
- Bellingham, WA
National Provider Identifier
1194761155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00023012
- Practice address
- 3015 Squalicum Pkwy
Suite 120
Bellingham, WA 98225-1945 - Phone
- (360) 733-7974
- Fax
- (360) 676-2567
- NPI assigned
- Jun 20, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00023012 | WA | Primary |
Addresses
Primary practice location
3015 Squalicum Pkwy
Suite 120
Bellingham, WA 98225-1945
Mailing address
709 W Orchard Dr
Suite #4
Bellingham, WA 98225-1766
Phone (360) 318-8800
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 423898036 | Other | WA | GROUP HEALTH COOPERATIVE |
| 8924277 | Other | WA | LABOR & INDUSTRIES (CV) |
| 1053545 | Medicaid | WA | |
| 33183 | Other | WA | REGENCE BLUESHIELD |
| 080145445 | Other | WA | RAILROAD MEDICARE |
| 0132425 | Other | WA | LABOR & INDUSTRIES (REG) |
Other names 1
- S Harry Herdman
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1194761155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 W ORCHARD DR",
"address_2": "SUITE #4",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251766",
"telephone_number": "360-318-8800",
"fax_number": "360-318-1085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 SQUALICUM PKWY",
"address_2": "SUITE 120",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251945",
"telephone_number": "360-733-7974",
"fax_number": "360-676-2567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERDMAN",
"first_name": "STEPHEN",
"middle_name": "HARRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00023012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH COOPERATIVE",
"identifier": "423898036",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES (CV)",
"identifier": "8924277",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053545",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUESHIELD",
"identifier": "33183",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080145445",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES (REG)",
"identifier": "0132425",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "S",
"last_name": "HERDMAN",
"middle_name": "HARRY",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.