Jesse Dewayne Herron, APRN, CRNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.017099 Issued in IL

Practice address

912 S Wood St # Mc913
Chicago, IL 60612-4300

Phone

(312) 996-2200

NPI assigned

Dec 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jherron17108@uihealth.direct-ci.com

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1841706371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST # MC913",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300",
            "telephone_number": "312-996-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "JESSE",
        "middle_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "credential": "APRN, CRNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "AL",
            "license": "1-144296",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041460500",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.017099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herron Medical Services, S.C.
• Burnetta Herron, M.D.
• Denise Herron
• Devere J Herron, D.D.S.
• James R Herron, MD
• Mary Downs Herron, LCSW
• Mia Herron
• Monica M Herron, PA-C
• Sally M Herschman, LCSW
• Natanel Herscovitch, MD

• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.