Brian W. Herrbold, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2004008549 Issued in MO

Practice address

1241 W Stadium Blvd
Jefferson City, MO 65109-6023

Phone

(573) 556-7704

Fax

(573) 556-1714

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• The Curators of the University of Missouri

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1235126921
  Medicare reassignment NPD
• Curators of the University of Missouri

  • Durable Medical Equipment & Medical Supplies
  • Columbia, MO
  • NPI 1356963201
  NPD
• Curators of the University of Missouri

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1689650509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104240",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104240",
            "telephone_number": "573-556-7704",
            "fax_number": "573-556-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096023",
            "telephone_number": "573-556-7704",
            "fax_number": "573-556-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRBOLD",
        "first_name": "BRIAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2004008549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208443408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Henry, PHD
• Nelson Henry, DDS
• Teri Hensley
• Lauren Henson, LPN
• Sarah Jean Hentges, LPN
• Thomas E Hetherington, MD
• Taylor Heying
• Jennifer Diane Hickman, P.T.
• Amber Hicks
• Jeremy Higbie

• Pediatrics Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.