Organization Active NPI

Thomas J Herbst MD PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Ann Arbor, MI
National Provider Identifier
1528358728
Registry record updated Apr 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
4301057770 Issued in MI
Legal business name
THOMAS J HERBST MD PLLC
Practice address
202 E Washington St Ste 708
Ann Arbor, MI 48104-2017
Phone
(734) 327-9322
NPI assigned
Apr 9, 2011
Last updated
Apr 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2011

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

Authorized official

Name
Dr. Thomas J Herbst, MDNPI 1679571012
Title
Sole Proprietor
Phone
(734) 327-9322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 4301057770 MI
Adolescent and Children Mental Health Clinic/Center 261QM0855X 4301057770 MI Primary

Addresses

Primary practice location

202 E Washington St Ste 708
Ann Arbor, MI 48104-2017

Mailing address

202 E Washington St Ste 708
Ann Arbor, MI 48104-2017
Phone (734) 327-9322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000754 MI Part B Supplier - Clinic/Group Practice 0244498772 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI; Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

202 E Washington St
Ste 708
Ann Arbor, MI 48104
Phone (734) 327-9322

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302307200000",
    "number": "1528358728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 708",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-327-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 708",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-327-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J HERBST MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-09",
        "last_updated": "2011-04-09",
        "status": "A",
        "authorized_official_last_name": "HERBST",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "734-327-9322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "4301057770",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MI",
            "license": "4301057770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.