Active NPI
Thomas M Herrmann, DPM
- Podiatrist
- Ephrata, PA
National Provider Identifier
1710964523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC002598L
- Practice address
- 804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635 - Phone
- (717) 733-2251
- NPI assigned
- Dec 22, 2005
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC002598L | PA | Primary |
Addresses
Primary practice location
804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635
Mailing address
804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635
Phone (717) 733-2251
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01319201 | Other | PA | CAPITAL BLUE CROSS |
| 107474 | Other | PA | HIGHMARK BLUE SHIELD |
| 1515010 | Other | PA | GATEWAY |
| 0009566880001 | Medicaid | PA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC002598L | PA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1710964523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 GRANDVIEW DR",
"address_2": "STE 1",
"city": "EPHRATA",
"state": "PA",
"postal_code": "175221635",
"telephone_number": "717-733-2251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 GRANDVIEW DR",
"address_2": "STE 1",
"city": "EPHRATA",
"state": "PA",
"postal_code": "175221635",
"telephone_number": "717-733-2251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRMANN",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC002598L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01319201",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "107474",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1515010",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009566880001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ephrata, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.