Individual provider Active NPI

Thomas A Herrmann, MD

  • Family Medicine Physician
  • Vienna, WV
National Provider Identifier
1447253208
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16285 Issued in WV
Practice address
800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131
Phone
(304) 485-3300
Fax
(304) 485-3317
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.086160 OH
Family Medicine Physician 207Q00000X 16285 WV Primary

Addresses

Primary practice location

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131

Mailing address

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4131
Phone (304) 485-3300

Other identifiers 2

IdentifierTypeStateIssuer
0257323MedicaidOH
0052734000MedicaidWV

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address therrmann112970@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address therrmann112970@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100412000000 WV Practitioner - Family Practice 4587663760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Camden-Clark Physician Corporation CurrentSince Apr 1, 2023 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

610 Washington Blvd
Belpre, OH 45714
Phone (740) 315-1060

610 Washington Blvd
#1
Belpre, OH 45714
Phone (740) 423-5055

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

800 Grand Central Mall
Ste 13
Vienna, WV 26105
Phone (304) 485-3300

800 Grand Central Mall
Ste 4
Vienna, WV 26105
Phone (304) 485-3300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1447253208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054131",
            "telephone_number": "304-485-3300",
            "fax_number": "304-485-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054131",
            "telephone_number": "304-485-3300",
            "fax_number": "304-485-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.086160",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "16285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0257323",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052734000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therrmann112970@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Grand Central Mall Ste 4",
            "city": "Vienna",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261054100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "therrmann112970@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Grand Central Mall Ste 4",
            "city": "Vienna",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261054100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.