Individual provider Active NPI

William Paul Herriott, MMS, PA-C

  • Physician Assistant
  • Naples, FL
National Provider Identifier
1245564962
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110027 Issued in FL
Practice address
1108 Goodlette Rd N
Naples, FL 34102-5451
Phone
(239) 434-0303
Fax
(239) 262-8730
NPI assigned
Sep 28, 2009
Last updated
Feb 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110027 FL Primary

Addresses

Primary practice location

1108 Goodlette Rd N
Naples, FL 34102-5451

Mailing address

15051 S Tamiami TRL
Suite 203
Fort Myers, FL 33908-5182
Phone (239) 437-8810

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110027FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1245564962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15051 S TAMIAMI TRL",
            "address_2": "SUITE 203",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085182",
            "telephone_number": "239-437-8810",
            "fax_number": "239-313-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 GOODLETTE RD N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025451",
            "telephone_number": "239-434-0303",
            "fax_number": "239-262-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIOTT",
        "first_name": "WILLIAM",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-28",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.