Norman C Herron, MD
Individual provider Active NPI Pediatrics Physician · Anchorage, AK
NPI 1881624344 · NPPES record last updated May 4, 2017
Key facts
- NPI
- 1881624344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 3147 (AK)
- Practice address
- 3340 Providence Dr
#452
Anchorage, AK 99508-4691 - Phone
- (907) 562-2120
- Fax
- (907) 562-6527
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090629000340 | AK | Practitioner - Pediatric Medicine | 7012090517 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3147 | AK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Pediatrics | Current |
Accepting new patients |
| Latouche Pediatrics, LLC | Past |
Accepting new patients | |
| Providence Health & Services Washington | Past | Accepting new patients | |
| Latouche Pediatrics | Pediatrics | Past | Accepting new patients |
Locations
3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104
1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281
Interoperability endpoints
- nherron1996@direct.peacehealth.org
- normanherron@latouchepe.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 3147 | AK | Yes |
Addresses
Primary practice location
3340 Providence Dr
#452
Anchorage, AK 99508-4691
Mailing address
3340 Providence Dr
#452
Anchorage, AK 99508-4691
Phone (907) 562-2120
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1011284 | Medicaid | AK |
Other providers in Anchorage, AK
- Crystal Herring
- Marcel Page Herring
- Amar Herrington
- Martha Jane Herriott
- Amber Herrmann
- Elizabeth J. Hersh
- Sharon Anne Hess-Winter
- Clara Jeanette Hess
- Diana Hess
- Lavonne Hess
All providers in Anchorage, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.