Individual provider Active NPI

Jeanine Herdman, M.D.

  • Child & Adolescent Psychiatry Physician
  • MC Murray, PA
National Provider Identifier
1730384199
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD437568 Issued in PA
Practice address
453 Valley Brook Rd Ste 500
MC Murray, PA 15317-3378
Phone
(724) 941-8760
Fax
(724) 941-8795
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD437568 PA Primary

Addresses

Primary practice location

453 Valley Brook Rd Ste 500
MC Murray, PA 15317-3378

Mailing address

174 E Highland Dr
MC Murray, PA 15317-3510
Phone (724) 941-8760

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD437568PAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1730384199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 E HIGHLAND DR",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173510",
            "telephone_number": "724-941-8760",
            "fax_number": "724-941-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 VALLEY BROOK RD STE 500",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173378",
            "telephone_number": "724-941-8760",
            "fax_number": "724-941-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDMAN",
        "first_name": "JEANINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD437568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Murray, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.