Individual provider Active NPI

Robert David Herring Jr., M.D.

  • Family Medicine Physician
  • Hattiesburg, MS
National Provider Identifier
1487966750
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22699 Issued in MS
Practice address
105 Thornhill Dr
Hattiesburg, MS 39402-1548
Phone
(601) 261-3737
Fax
(601) 579-5240
NPI assigned
Jul 2, 2010
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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 65255 CO
Family Medicine Physician 207Q00000X 22699 MS Primary

Addresses

Primary practice location

105 Thornhill Dr
Hattiesburg, MS 39402-1548

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3737

Other identifiers 1

IdentifierTypeStateIssuer
01032001MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rherring120067@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20140103000405 MS Practitioner - Family Practice 7113822545 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65255COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Medical Services of Ms, Inc CurrentSince May 19, 2015 Accepting new patients
Claiborne County Hospital CurrentSince Apr 30, 2015 Accepting new patients
Hattiesburg Clinic PA CurrentSince Feb 28, 2022 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Feb 28, 2022 Accepting new patients
Southern Health Corp. of Houston, Inc Current Accepting new patients
Hattiesburg Clinic PA Family Medicine PastSince Mar 6, 2022 Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

105 Thornhill Dr
Hattiesburg, MS 39402
Phone (601) 261-3737

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1002 E Madison St
Houston, MS 38851
Phone (601) 456-3701

123 McComb Ave
Port Gibson, MS 39150
Phone (601) 437-5141

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Organizations & group practices 6

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1487966750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3737",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 THORNHILL DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021548",
            "telephone_number": "601-261-3737",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRING",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "65255",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "22699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01032001",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rherring120067@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "105 Thornhill Dr",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394021548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.