Individual provider Active NPI

Lawrence J Herberholz, MD

  • Surgery Physician
  • Scottsboro, AL
National Provider Identifier
1619977378
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
23961 Issued in AL
Practice address
911 S Broad St
Scottsboro, AL 35768-2509
Phone
(256) 259-0185
Fax
(256) 259-0317
NPI assigned
Jul 26, 2005
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 23961 AL Primary

Addresses

Primary practice location

911 S Broad St
Scottsboro, AL 35768-2509

Mailing address

911 S Broad St
Scottsboro, AL 35768-2509
Phone (256) 259-0185

Other identifiers 3

IdentifierTypeStateIssuer
009990335MedicaidAL
529923150MedicaidAL
51524140OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20041122000765 AL Practitioner - General Surgery 6901861673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highlands Professional ServicesGroup PAC ID 0648666198, 20 clinicians

Practice addresses (Care Compare)

380 Woods Cove Rd
Scottsboro, AL 35768-2428
Phone (256) 218-3405

408 Taylor St
Scottsboro, AL 35768-2424
Phone (256) 259-5211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy116
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux108
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23961ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Surgical Services LLC Surgery CurrentSince Mar 1, 2015 Accepting new patients
Highlands Professional Services Surgery CurrentSince May 7, 2023 Accepting new patients
Scottsboro OB GYN Specialists LLC CurrentSince Oct 1, 2001 Accepting new patients
Charles B. Lovelady, M.D., L.L.C. Surgery Past Accepting new patients
Jackson County Healthcare Authority Past Accepting new patients
Gurinder Doad MD PHD Past Accepting new patients

Locations

380 Woods Cove Rd
Scottsboro, AL 35768
Phone (256) 218-3579

380 Woods Cove Rd
Ste B
Scottsboro, AL 35768
Phone (256) 259-0185

408 Taylor St
Scottsboro, AL 35768
Phone (256) 259-5211

509 Burlington St
Scottsboro, AL 35768
Phone (256) 259-4817

911 S Broad St
Scottsboro, AL 35768
Phone (256) 259-0185

Interoperability endpoints

  • Direct secure messaging: lawrence.herberholz.1@29332.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1619977378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 S BROAD ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682509",
            "telephone_number": "256-259-0185",
            "fax_number": "256-259-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 S BROAD ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682509",
            "telephone_number": "256-259-0185",
            "fax_number": "256-259-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERHOLZ",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "23961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009990335",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529923150",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51524140",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.