Individual provider Active NPI

Jeffrey Michael Hermann, MD

  • Obstetrics & Gynecology Physician
  • Denison, TX
National Provider Identifier
1669560033
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K2712 Issued in TX
Practice address
5012 S US Highway 75
Suite 240
Denison, TX 75020-4587
Phone
(903) 416-6260
Fax
(903) 416-6261
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K2712 TX Primary

Addresses

Primary practice location

5012 S US Highway 75
Suite 240
Denison, TX 75020-4587

Mailing address

5012 S US Highway 75
Suite 240
Denison, TX 75020-4587
Phone (903) 416-6260

Other identifiers 2

IdentifierTypeStateIssuer
P00812130OtherTXRR MEDICARE
170941202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050201000140 TX Practitioner - Obstetrics/Gynecology 8921058652 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K2712TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Jan 1, 2015 Accepting new patients
Hercare Women'S Specialty Clinic of Bonham, PA Obstetrics & Gynecology PastSince Dec 1, 2004 Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1669560033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75",
            "address_2": "SUITE 240",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204587",
            "telephone_number": "903-416-6260",
            "fax_number": "903-416-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75",
            "address_2": "SUITE 240",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204587",
            "telephone_number": "903-416-6260",
            "fax_number": "903-416-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K2712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00812130",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170941202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.