Individual provider Active NPI

Kent A Herron, DC

  • Chiropractor
  • West Frankfort, IL
National Provider Identifier
1750473443
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006817 Issued in IL
Practice address
607 W Oak St
West Frankfort, IL 62896-2537
Phone
(618) 937-3509
Fax
(618) 937-3500
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006817 IL Primary

Addresses

Primary practice location

607 W Oak St
West Frankfort, IL 62896-2537

Mailing address

607 W Oak St
West Frankfort, IL 62896-2537
Phone (618) 937-3509

Other identifiers 3

IdentifierTypeStateIssuer
038006817MedicaidIL
350038040OtherILRR MEDICARE
1517948OtherILFUNDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000143 IL Practitioner - Chiropractic 6406915222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Herron Rehab and Wellness Center, S.C.Group PAC ID 3274671870, 4 clinicians

Practice addresses (Care Compare)

607 W Oak St
West Frankfort, IL 62896-2537
Phone (618) 937-3509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Herron Rehab and Wellness Center, S.C. Chiropractor CurrentSince Sep 29, 2009 Accepting new patients

Locations

607 W Oak St
West Frankfort, IL 62896
Phone (618) 932-2137

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1750473443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W OAK ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962537",
            "telephone_number": "618-937-3509",
            "fax_number": "618-937-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W OAK ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962537",
            "telephone_number": "618-937-3509",
            "fax_number": "618-937-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "KENT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038006817",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350038040",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FUNDS",
            "identifier": "1517948",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.