Paul Russell Hercules IV, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004295 Issued in WV

Practice address

208 Old Mill Rd
Martinsburg, WV 25401-9219

Phone

(304) 263-5680

NPI assigned

Mar 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Panhandle Home Health Inc

  • Home Health Agency
  • Martinsburg, WV
  • NPI 1174588750
  NPD (past)

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1760914568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019219",
            "telephone_number": "304-263-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019219",
            "telephone_number": "304-263-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERCULES",
        "first_name": "PAUL",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Hensell
• Casey Morgan Hensler
• Colton Henson, DPT
• Laura Henton Parsons, DNP
• Sharon Herbert
• Dale Steven Herman, D.P.M.
• Carmen Hernandez-Garcia
• Lucero Hernandez-Knott
• Kristie T Hershman
• Anne Sparks Hess

• Physical Therapist in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.