Lisa J Herrin, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

H4400 Issued in TX

Practice address

4200 South Fwy Ste 100
Fort Worth, TX 76115-1407

Phone

(817) 750-7334

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8044/brand/1/csg/1/fhir/r4

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.

• Doctormom,MD Pediatrics PLLC

  dba Dr. Lisa Herrin

  • Primary Care Clinic/Center
  • Burleson, TX
  • NPI 1720403371
  NPD (past) Authorized official
• Pediatric Urgent Care Center of Fort Worth, P.a..

  dba Fort Worth Concierge Plus

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1851668149

  Pediatric Emergency Medicine

  NPD
• Telemedicine Advantage Concierge Urgent Care

  dba Concierge Urgent Care

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1376165191
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1366535445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 SAN PEDRO AVE STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324363",
            "telephone_number": "210-981-1975",
            "fax_number": "817-568-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151407",
            "telephone_number": "817-750-7334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 SW Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Burleson",
            "state": "TX",
            "postal_code": "760285711",
            "country_code": "US",
            "telephone_number": "817-426-0757",
            "fax_number": "817-426-4109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "H4400",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H4400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP NPI NUMBER",
            "identifier": "1003887985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTHEALTH PIN",
            "identifier": "1729016",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PIN",
            "identifier": "9057411",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140442857",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX IND PIN",
            "identifier": "8M3077",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132731409",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132731411",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "6811699",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163314101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "4586688",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GRP PIN",
            "identifier": "0087LE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniela Herrera, CRNP
• Eduardo R. Herrera, M.D.
• Gabriela Herrera
• Pamela D Herrera, RN
• Joshua Michael Herrin, CSFA
• Johnishau Herring-Smith, LCSW
• Kelsey Herring, SLP
• Rachelle Herring, M.D.
• Andrea Herron, RBT
• Soheila Hesami, MD

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.