NPIMap

Individual provider Active NPI

Deborah Ann Herrmann, M.D.

  • Family Medicine Physician
  • Marshall, MO
National Provider Identifier
1508862756
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36988 Issued in MO
Practice address
2305 S Highway 65 BLDG a
Marshall, MO 65340-3702
Phone
(660) 886-7800
Fax
(660) 831-3306
NPI assigned
Jun 22, 2005
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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 36988 MO Primary
Family Medicine Physician 207Q00000X 35894 IA

Addresses

Primary practice location

2305 S Highway 65 BLDG a
Marshall, MO 65340-3702

Mailing address

2305 S Highway 65 BLDG a
Marshall, MO 65340-3702
Phone (660) 886-7800

Other identifiers 6

IdentifierTypeStateIssuer
36988OtherMOLICENSE
38157OtherIABLUE SHIELD OF IOWA
P00192136OtherIARAILROAD MEDICARE
18134090OtherMOBCBS PROV #
0454215MedicaidIA
203230651MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DEBORAHHERRMANN@fitzgibbon.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070316000340 MO Practitioner - Family PracticePractitioner - Emergency Medicine 0749255651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2305 S 65 Hwy
Marshall, MO 65340-3702

2305 S Hwy 65
Marshall, MO 65340-3702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35894IAMDFamily Medicine Physician
36988MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Fitzgibbon Memorial Hospital Inc CurrentSince Sep 15, 2019 Accepting new patients
John Fitzgibbon Memorial Hospital, Inc. Current Accepting new patients
John Fitzgibbon Memorial Hospital Inc. CurrentSince Sep 15, 2019 Accepting new patients
Cah Acquisition Company 6 LLC Past Accepting new patients
Fitzgibbon Health Services Past Accepting new patients

Locations

815 E Broadway St
Brunswick, MO 65236
Phone (660) 548-3161

600 W Morrison St
Fayette, MO 65248
Phone (660) 248-2900

2301 S Highway 65
Marshall, MO 65340
Phone (660) 831-5001

2303 S Highway 65
Ste A
Marshall, MO 65340
Phone (660) 831-1175

2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730

2305 S Highway 65
Bldg A
Marshall, MO 65340
Phone (660) 886-7800

212 College St
Pilot Grove, MO 65276
Phone (660) 831-3728

420 W Front St
Slater, MO 65349
Phone (660) 529-2251

Interoperability endpoints

  • Direct secure messaging: deborahherrmann@fitzgibbon.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1508862756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 S HIGHWAY 65 BLDG A",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-7800",
            "fax_number": "660-831-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 S HIGHWAY 65 BLDG A",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-7800",
            "fax_number": "660-831-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36988",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "35894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "36988",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IOWA",
            "identifier": "38157",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00192136",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "18134090",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0454215",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203230651",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEBORAHHERRMANN@fitzgibbon.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Deborah Herrmann John Fitzgibbon Memorial Hospital DIRECT Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2305 S Highway 65 Bldg A",
            "city": "Marshall",
            "state": "MO",
            "country_code": "US",
            "postal_code": "653403702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshall, MO

Sources for this page

Verify at the official NPI Registry.