NPIMap

Individual provider Active NPI

Kim R Herman, M.D.

  • Family Medicine Physician
  • Denton, MD
National Provider Identifier
1679757330
Registry record updated Aug 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D71196 Issued in MD
Practice address
836 S 5TH Ave
Denton, MD 21629
Phone
(410) 479-5900
NPI assigned
Dec 18, 2007
Last updated
Aug 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2018

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 35090542 OH
Family Medicine Physician 207Q00000X D71196 MD Primary

Addresses

Primary practice location

836 S 5TH Ave
Denton, MD 21629

Mailing address

920 Elkridge Landing Rd
Linthicum, MD 21090-2917
Phone (443) 462-5010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110516000826 MD Practitioner - Family Practice 2668555186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

2540 Centreville Rd
Centreville, MD 21617-2681
Phone (410) 822-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D71196MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. Family Medicine CurrentSince Jan 5, 2011 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 5, 2011 Accepting new patients
Shore Health System, Inc PastSince Aug 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Eastern Shore Emergency Medicine Physicians, LLC Past Accepting new patients

Locations

300 Byrn St
Cambridge, MD 21613
Phone (410) 228-5511

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

836 S 5th Ave
Denton, MD 21629
Phone (410) 479-0434

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

Interoperability endpoints

  • Direct secure messaging: kherman11471@direct.umm.edu

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shore Health System IncEaston, MD, CCN 210037 Hospital Corporate Director Aug 1, 2022
University of Maryland Shore Medical Center at ChestertownChestertown, MD, CCN 210030 Hospital Corporate Director Aug 1, 2022

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 7

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534032000000",
    "number": "1679757330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "21629",
            "telephone_number": "410-479-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "KIM",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2018-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35090542",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D71196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

Verify at the official NPI Registry.