Individual provider Active NPI

Adrian L. Herren, MD

  • Anesthesiology Physician
  • Pensacola, FL
National Provider Identifier
1285636118
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME83305 Issued in FL
Practice address
4901 Grande Dr
Pensacola, FL 32504-5935
Phone
(850) 477-7042
Fax
(850) 474-9060
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME83305 FL Primary

Addresses

Primary practice location

4901 Grande Dr
Pensacola, FL 32504-5935

Mailing address

4901 Grande Dr
Pensacola, FL 32504-5935
Phone (850) 477-7042

Other identifiers 8

IdentifierTypeStateIssuer
050091146OtherFLRAILROAD MEDICARE
009909845MedicaidAL
592-15544OtherALBLUE CROSS BLUE SHIELD
C164OtherFLHEALTH FIRST NETWORK
131511MedicaidAL
59167824OtherALBLUECROSS & BLUESHIELD
266122500MedicaidFL
62998OtherFLBLUECROSS & BLUESHIELD

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
ME83305FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Arkansas Anesthesiology Associates P.a. Anesthesiology Past Accepting new patients
Arkansas Methodist Hospital Corporation Anesthesiology Past Accepting new patients
Arkansas Methodist Hospital Corporation Past Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients

Organizations & group practices 4

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1285636118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERREN",
        "first_name": "ADRIAN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME83305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050091146",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009909845",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "592-15544",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST NETWORK",
            "identifier": "C164",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131511",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "59167824",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266122500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "62998",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.