Individual provider Active NPI

Kirabo Herbert

  • Pediatrics Physician
  • Clayton, NC
National Provider Identifier
1770018186
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202000892 Issued in NC
Practice address
104 Medspring Dr Ste 100
Clayton, NC 27520-9687
Phone
(919) 359-3500
NPI assigned
Apr 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 202000892 NC Primary

Addresses

Primary practice location

104 Medspring Dr Ste 100
Clayton, NC 27520-9687

Mailing address

2406 Blue Ridge Rd Ste 100
Raleigh, NC 27607-6692

Other practice location 1

2406 Blue Ridge Rd Ste 100
Raleigh, NC 27607-6692
Phone (919) 786-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170519000385 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2365719523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202000892NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA CurrentSince Jul 12, 2020 Accepting new patients

Locations

104 Medspring Dr
#100
Clayton, NC 27520
Phone (919) 359-3500

2406 Blue Ridge Rd
Ste 100
Raleigh, NC 27607
Phone (919) 786-5001

Interoperability endpoints

  • Direct secure messaging: kiraboherbert@jmp.allscriptsdirect.net

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": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1770018186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MEDSPRING DR STE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209687",
            "telephone_number": "919-359-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2406 Blue Ridge Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076692",
            "country_code": "US",
            "telephone_number": "919-786-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "KIRABO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-23",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "202000892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.