Mark I Herron

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

33.5565 Issued in OH

Practice address

4662 Larwell Dr
Columbus, OH 43220-3621

Phone

(614) 442-6754

Fax

(614) 442-6737

NPI assigned

Jul 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• D&E Miller Enterprises, Inc.

  dba TMC Medical Massage & Movement

  • Medical Specialty Clinic/Center
  • Columbus, OH
  • NPI 1770876310
  NPD

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1386377398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4662 LARWELL DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203621",
            "telephone_number": "614-442-6754",
            "fax_number": "614-442-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4662 LARWELL DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203621",
            "telephone_number": "614-442-6754",
            "fax_number": "614-442-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "MARK",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.5565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "33.5565",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://tmc-ua.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "614-442-6737",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "4662 Larwell Dr",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432203621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carson Herron, MD
• Edwina Renee Herron
• Holly Herron, CNP
• Jaquayla M Herron
• Julie Herron, PC
• Tabatha Herron, LMT
• Stephen J Hersey, M.D.
• Dulce Hershberger, MSW, LISWS
• Jenna Ruth Hershberger, LPCC
• Ray Elwin Hershberger, MD

• Massage Therapist in Columbus, OH
• Providers in Columbus, OH by specialty
• Massage Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.