Individual provider Active NPI

Matthew L Hershberger, PHARMD

  • Pharmacist
  • Port Clinton, OH
National Provider Identifier
1548738214
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03135393 Issued in OH
Practice address
615 Fulton St
Port Clinton, OH 43452-2001
Phone
(419) 732-4009
NPI assigned
Nov 11, 2018
Last updated
Mar 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03135393 OH Primary

Addresses

Primary practice location

615 Fulton St
Port Clinton, OH 43452-2001

Mailing address

133 Avon Belden Rd
Avon Lake, OH 44012-1605
Phone (814) 232-0648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03135393OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Discount Drug Mart Inc Past Accepting new patients
Discount Drug Mart Inc Past Accepting new patients

Organizations & group practices 2

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": "1541894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1548738214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 AVON BELDEN RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121605",
            "telephone_number": "814-232-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522001",
            "telephone_number": "419-732-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHBERGER",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-11",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03135393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.