Individual provider Active NPI

Thomas M Herron, M.D.

  • Pediatrics Physician
  • Gig Harbor, WA
National Provider Identifier
1689690448
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00023767 Issued in WA
Practice address
4700 Point Fosdick Dr NW
Suite 319
Gig Harbor, WA 98335-1706
Phone
(253) 853-3888
Fax
(253) 853-7393
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00023767 WA Primary

Addresses

Primary practice location

4700 Point Fosdick Dr NW
Suite 319
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr NW
Suite 319
Gig Harbor, WA 98335-1706
Phone (253) 853-3888

Other identifiers 1

IdentifierTypeStateIssuer
1017995MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00023767WAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1689690448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 319",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-853-3888",
            "fax_number": "253-853-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 319",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-853-3888",
            "fax_number": "253-853-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00023767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017995",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.