Charles B Herrin, M.D.

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

MD11902 Issued in TN

Practice address

2300 Pavilion Dr
Kingsport, TN 37660-4622

Phone

(423) 857-5571

Fax

(423) 857-5237

NPI assigned

Jun 10, 2006

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

State licenses

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.

• Emergency Care Physicians, Inc.

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1669410304
  NPD (past)
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Kingsport, TN
  • NPI 1417050980
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821039512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 PAVILION DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604622",
            "telephone_number": "423-857-5571",
            "fax_number": "423-857-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PAVILION DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604622",
            "telephone_number": "423-857-5571",
            "fax_number": "423-857-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "CHARLES",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "TN",
            "license": "MD11902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN01X8",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3837993",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatrice Sharon Herbert, LPN
• John R Hereford, MD
• Heather Hermes, BS
• Clark Rafael Hernandez, PAC
• Jill Marie Herren, LPTA
• Nancy Hess, PT
• Sarah N. Hewitt
• Hannah Hicks
• Ian Jackson Hicks, RN
• Luke Evan Hicks

• Addiction Medicine (Psychiatry & Neurology) Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.