Individual provider Active NPI

George Herda, M.D.

  • General Practice Physician
  • Madison, TN
National Provider Identifier
1215938980
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD14613 Issued in TN
Practice address
1616 Gallatin Pike N
Madison, TN 37115-2104
Phone
(615) 865-8500
Fax
(615) 860-8061
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD14613 TN Primary

Addresses

Primary practice location

1616 Gallatin Pike N
Madison, TN 37115-2104

Mailing address

1616 Gallatin Pike N
Madison, TN 37115-2104
Phone (615) 865-8500

Other identifiers 1

IdentifierTypeStateIssuer
3144727OtherTNBLUE CROSS BLUE SHIELD TN

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

State licenses

LicenseStateTypeSpecialty
MD14613TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Urgent Care Associates, LLC PastSince Dec 11, 2000 Accepting new patients
Tennessee Urgent Care Associates, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1215938980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 GALLATIN PIKE N",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152104",
            "telephone_number": "615-865-8500",
            "fax_number": "615-860-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 GALLATIN PIKE N",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152104",
            "telephone_number": "615-865-8500",
            "fax_number": "615-860-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDA",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD14613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "3144727",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.