Active NPI
Jefferson D Herring, MD
- Internal Medicine Physician
- Hollywood, FL
National Provider Identifier
1700989688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME84985
- Practice address
- 4015 Primary Pembroke Road
Memorial Primary Care Center
Hollywood, FL 33021 - Phone
- (954) 987-1551
- Fax
- (954) 752-8214
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME84985 | FL | Primary |
Addresses
Primary practice location
4015 Primary Pembroke Road
Memorial Primary Care Center
Hollywood, FL 33021
Mailing address
4105 Primary Pembroke Road
Memorial Primary Care Center
Hollywood, FL 33021
Phone (954) 987-1551
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME84985 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700989688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 PRIMARY PEMBROKE ROAD",
"address_2": "MEMORIAL PRIMARY CARE CENTER",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-987-1551",
"fax_number": "954-752-8214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4015 PRIMARY PEMBROKE ROAD",
"address_2": "MEMORIAL PRIMARY CARE CENTER",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-987-1551",
"fax_number": "954-752-8214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRING",
"first_name": "JEFFERSON",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME84985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.