Individual provider Active NPI

Brian Horst Herb, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1477792562
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2253 Issued in OK
Practice address
7919 Mid America Blvd Ste 250
Oklahoma City, OK 73135-6610
Phone
(405) 855-6000
NPI assigned
Feb 12, 2009
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1086048 NU
Physician Assistant 363A00000X 2253 OK Primary

Addresses

Primary practice location

7919 Mid America Blvd Ste 250
Oklahoma City, OK 73135-6610

Mailing address

7919 Mid America Blvd Ste 250
Oklahoma City, OK 73135-6610
Phone (405) 855-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140103001210 OK Practitioner - Physician Assistant 5991932170 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2253OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Immediate Care of Oklahoma LLC CurrentSince Nov 9, 2013 Accepting new patients

Locations

11808 S May Ave
Oklahoma City, OK 73170
Phone (405) 735-2370

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1477792562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7919 MID AMERICA BLVD STE 250",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731356610",
            "telephone_number": "405-855-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7919 MID AMERICA BLVD STE 250",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731356610",
            "telephone_number": "405-855-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERB",
        "first_name": "BRIAN",
        "middle_name": "HORST",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1086048",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.