Organization Active NPI

Larry D Herron MD Inc

  • Orthopaedic Surgery Physician
  • San Luis Obispo, CA
National Provider Identifier
1306035902
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G25538 Issued in CA
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Dr. Larry Donald Herron, MDNPI 1730109968
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)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20051212000391 CA Part B Supplier - Clinic/Group Practice 1153342787 Practice locations: San Luis Obispo, CA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.