Individual provider Active NPI

Erin Nicole Herrmann, PA-C

  • Physician Assistant
  • Keller, TX
National Provider Identifier
1306237805
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09664 Issued in TX
Practice address
651 S Main St
Suite 105
Keller, TX 76248-7038
Phone
(817) 741-0800
Fax
(817) 741-0805
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X PA09664 TX Primary

Addresses

Primary practice location

651 S Main St
Suite 105
Keller, TX 76248-7038

Mailing address

651 S Main St
Suite 105
Keller, TX 76248-7038
Phone (817) 741-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506000383 TX Practitioner - Physician Assistant 2466771894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ved V Aggarwal MD PAGroup PAC ID 3072592252, 11 clinicians

Practice addresses (Care Compare)

1000 Lipscomb St
Suite 110
Fort Worth, TX 76104-3181
Phone (817) 348-8600

651 S Main St
Suite 105
Keller, TX 76248-7037
Phone (817) 348-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09664TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ved V Aggarwal MD PA CurrentSince Jul 13, 2015 Accepting new patients
Ved V Aggarwal MD PA CurrentSince Jul 13, 2015 Accepting new patients

Locations

1000 Lipscomb St
Ste 110
Ft Worth, TX 76104

651 S Main St
Ste 105
Keller, TX 76248
Phone (817) 741-0800

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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1306237805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 S MAIN ST",
            "address_2": "SUITE 105",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487038",
            "telephone_number": "817-741-0800",
            "fax_number": "817-741-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 S MAIN ST",
            "address_2": "SUITE 105",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487038",
            "telephone_number": "817-741-0800",
            "fax_number": "817-741-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.