Individual provider Active NPI

Jennifer C Herrell, CNM

  • Advanced Practice Midwife
  • Norton, VA
National Provider Identifier
1417212267
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024172894 Issued in VA
Practice address
102 15TH St NW Ste 301
Norton, VA 24273-1627
Phone
(276) 439-1470
NPI assigned
Jul 9, 2012
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024172894 VA Primary
Midwife 176B00000X 0892 KY
Midwife 176B00000X 3007455 KY

Addresses

Primary practice location

102 15TH St NW Ste 301
Norton, VA 24273-1627

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

1980 Holton Ave E Ste 301
Big Stone Gap, VA 24219-3367
Phone (276) 523-0390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151122000013 VA Practitioner - Certified Nurse Midwife (CNM) 2769613132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
0892KYMDPsychologist
3007455KYMDMidwife
0024172894VAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1417212267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 15TH ST NW STE 301",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731627",
            "telephone_number": "276-439-1470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1980 Holton Ave E Ste 301",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193367",
            "country_code": "US",
            "telephone_number": "276-523-0390",
            "fax_number": "276-523-5514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRELL",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024172894",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "KY",
            "license": "0892",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "KY",
            "license": "3007455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, VA

Sources for this page

Verify at the official NPI Registry.