Jean M Herd, CFNP
Individual provider Active NPI Family Medicine Physician · Delphi, IN
NPI 1467488122 · NPPES record last updated Oct 27, 2017
Key facts
- NPI
- 1467488122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 71000682A (IN)
- Practice address
- 901 Prince William Rd Ste a
Delphi, IN 46923-1759 - Phone
- (765) 564-3016
- Fax
- (765) 564-2608
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110428000635 | IN | Order and Referring Only - Nurse Practitioner | 2163327602 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000682A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Purdue University | Past | Accepting new patients | |
| Trustees of Purdue University | Past | Accepting new patients | |
| Trustees of Purdue University | Past | Accepting new patients |
Interoperability endpoints
- jean.herd.1@23284.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 71000682A | IN | Yes |
Addresses
Primary practice location
901 Prince William Rd Ste a
Delphi, IN 46923-1759
Mailing address
901 Prince William Rd Ste a
Delphi, IN 46923-1759
Phone (765) 564-3016
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300005107 | Medicaid | IN |
Other providers in Delphi, IN
- Julian Leandro Gallegos
- Leah Gwin
- Kayla Jealea Hamstra
- Jennifer L Hendrickson
- Melinda Hendrix
- Hook-Superx LLC
- Stephanie Hostetler
- Anne Hunte
- Sydney Jablonski
- Justin Jargstorf
All providers in Delphi, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.