Individual provider Active NPI

Rudy B Herrera, DC, FNP

  • Family Nurse Practitioner
  • Wasco, CA
National Provider Identifier
1336119684
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F1212429 Issued in CA
Practice address
1217 7TH St
Wasco, CA 93280-1820
Phone
(661) 725-5500
NPI assigned
Jan 26, 2006
Last updated
Feb 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F1212429 CA Primary
Chiropractor 111N00000X DC21359 CA

Addresses

Primary practice location

1217 7TH St
Wasco, CA 93280-1820

Mailing address

5397 Truxtun Ave
Bakersfield, CA 93309-0641
Phone (661) 634-9900

Other identifiers 1

IdentifierTypeStateIssuer
F1212429OtherCAFNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151116001109 CA Practitioner - Chiropractic 4183679368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC21359CAMDChiropractor
21359CAMDSpeech-Language Pathologist
F1212429CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bakersfield Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rudy.herrera@baihp.directbygreenway.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1336119684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5397 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090641",
            "telephone_number": "661-634-9900",
            "fax_number": "661-634-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 7TH ST",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801820",
            "telephone_number": "661-725-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "RUDY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DC, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F1212429",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP",
            "identifier": "F1212429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.