Robert C Hermann, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

023982 Issued in GA

Practice address

340 Kennestone Hospital Blvd
Ste 200
Marietta, GA 30060-1121

Phone

(770) 281-5100

Fax

(678) 581-7100

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1790789188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "STE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068116",
            "telephone_number": "770-944-2830",
            "fax_number": "678-581-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KENNESTONE HOSPITAL BLVD",
            "address_2": "STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601121",
            "telephone_number": "770-281-5100",
            "fax_number": "678-581-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "023982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00267814C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00267814G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Marietta, GA
• Providers in Marietta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.

Verify at the official NPI Registry.