Active NPI
Oliver Wynn Herndon, M.D.
- Internal Medicine Physician
- Pittsburgh, PA
National Provider Identifier
1801909338
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 18, 2016.
- Section 1128a(3) exclusion effective May 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD067328L
- Practice address
- 500 N Lewis Run Rd
Suite 105
Pittsburgh, PA 15122-3056 - Phone
- (412) 460-1111
- Fax
- (412) 460-1465
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD067328L | PA | Primary |
Addresses
Primary practice location
500 N Lewis Run Rd
Suite 105
Pittsburgh, PA 15122-3056
Mailing address
500 N Lewis Run Rd
Suite 105
Pittsburgh, PA 15122-3056
Phone (412) 460-1111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204657 | Other | PA | HEALTH AMERICA |
| 210438 | Other | PA | UPMC |
| P00058817 | Other | PA | PALMETTO RR MEDICARE |
| 0018286180003 | Medicaid | PA |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD067328L | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801909338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N LEWIS RUN RD",
"address_2": "SUITE 105",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "151223056",
"telephone_number": "412-460-1111",
"fax_number": "412-460-1465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N LEWIS RUN RD",
"address_2": "SUITE 105",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "151223056",
"telephone_number": "412-460-1111",
"fax_number": "412-460-1465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNDON",
"first_name": "OLIVER",
"middle_name": "WYNN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD067328L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "204657",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC",
"identifier": "210438",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RR MEDICARE",
"identifier": "P00058817",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018286180003",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.