Active NPI
Robert David Herring Jr., M.D.
- Family Medicine Physician
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22699
- 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, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01032001 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65255 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keystone Medical Services of Ms, Inc | Current | Accepting new patients | |
| Claiborne County Hospital | Current | Accepting new patients | |
| Hattiesburg Clinic PA | Current | Accepting new patients | |
| Hattiesburg Clinic, PA | Current | Accepting new patients | |
| Southern Health Corp. of Houston, Inc | Current | Accepting new patients | |
| Hattiesburg Clinic PA | Family Medicine | Past | 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.
-
- Multi-Specialty Clinic/Center
- Hattiesburg, MS
- NPI 1740213446
-
- Emergency Medical Services (Emergency Medicine) Physician
- Port Gibson, MS
- NPI 1710238324
-
- Emergency Medicine Physician
- Hazlehurst, MS
- NPI 1174691059
-
dba Flowood Primary Care
- Primary Care Clinic/Center
- Flowood, MS
- NPI 1912600354
-
dba Trace Regional Hospital
- Certified Registered Nurse Anesthetist
- Houston, MS
- NPI 1942484365
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.