Active NPI
Kurt Bruce Herrin
- Physician Assistant
- Cleveland, OH
National Provider Identifier
1306653860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.009839RX
- Practice address
- 3675 W 148TH St
Cleveland, OH 44111-3138 - Phone
- (216) 906-9126
- NPI assigned
- Dec 17, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.009839RX | OH | Primary |
Addresses
Primary practice location
3675 W 148TH St
Cleveland, OH 44111-3138
Mailing address
3675 W 148TH St
Cleveland, OH 44111-3138
Phone (216) 906-9126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.009839RX | OH | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760659200000",
"number": "1306653860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3675 W 148TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441113138",
"telephone_number": "216-906-9126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3675 W 148TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441113138",
"telephone_number": "216-906-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRIN",
"first_name": "KURT",
"middle_name": "BRUCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-17",
"last_updated": "2025-10-17",
"certification_date": "2025-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.009839RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.