Active NPI
Larry D Herron MD Inc
- Orthopaedic Surgery Physician
- San Luis Obispo, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G25538
- Legal business name
- LARRY D HERRON MD INC
- Practice address
- 1304 Ella St Ste B
San Luis Obispo, CA 93401-4166 - Phone
- (805) 541-4700
- Fax
- (805) 541-4713
- NPI assigned
- Oct 18, 2007
- Last updated
- Feb 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Larry Donald Herron, MD
- Title
- President
- Phone
- (805) 541-4700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G25538 | CA | Primary |
Addresses
Primary practice location
1304 Ella St Ste B
San Luis Obispo, CA 93401-4166
Mailing address
1304 Ella St Ste B
San Luis Obispo, CA 93401-4166
Phone (805) 541-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051212000391 | CA | Part B Supplier - Clinic/Group Practice | 1153342787 | Practice locations: San Luis Obispo, CA |
National Provider Directory
National Provider DirectoryLocations
1304 Ella St
Ste A
Sn Luis Obisp, CA 93401
Phone (805) 541-1060
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Orthopaedic Surgery of the Spine Physician
- San Luis Obispo, CA
- NPI 1730109968
-
- Orthopaedic Surgery Physician
- San Luis Obispo, CA
- NPI 1174549570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192665600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580688000000",
"number": "1306035902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 ELLA ST STE B",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014166",
"telephone_number": "805-541-4700",
"fax_number": "805-541-4713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 ELLA ST STE B",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014166",
"telephone_number": "805-541-4700",
"fax_number": "805-541-4713"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARRY D HERRON MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-18",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A",
"authorized_official_last_name": "HERRON",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "DONALD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "805-541-4700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G25538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.