Individual provider Active NPI

William Brooks Herron, M.D.

  • Internal Medicine Physician
  • Fairhope, AL
National Provider Identifier
1962685958
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30904 Issued in AL
Practice address
150 S Ingleside St Ste 6
Fairhope, AL 36532-1804
Phone
(251) 990-1740
Fax
(251) 990-1831
NPI assigned
Dec 12, 2007
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30904 AL Primary

Addresses

Primary practice location

150 S Ingleside St Ste 6
Fairhope, AL 36532-1804

Mailing address

150 S Ingleside St Ste 6
Fairhope, AL 36532-1804
Phone (251) 990-1740

Other identifiers 1

IdentifierTypeStateIssuer
132173MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000389 AL Practitioner - Internal Medicine 9537346630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairhope Internal Medicine PCGroup PAC ID 6305884651, 9 clinicians

Practice addresses (Care Compare)

6 Medical Park
Fairhope, AL 36532-1804
Phone (251) 990-1740

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fairhope Internal Medicine PC Internal Medicine CurrentSince Jun 1, 2011 Accepting new patients
Medical Park OBGYN PC CurrentSince Jun 14, 2020 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

150 S Ingleside St
#6
Fairhope, AL 36532
Phone (251) 928-1222

188 Hospital Dr
Ste 402
Fairhope, AL 36532
Phone (251) 279-1245

6 Medical Park
Fairhope, AL 36532
Phone (251) 990-1740

Interoperability endpoints

  • Direct secure messaging: bherron13706@directinfirmaryhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1962685958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S INGLESIDE ST STE 6",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321804",
            "telephone_number": "251-990-1740",
            "fax_number": "251-990-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S INGLESIDE ST STE 6",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321804",
            "telephone_number": "251-990-1740",
            "fax_number": "251-990-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "WILLIAM",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "30904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132173",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.