Active NPI
Daryl L Hershberger, MD
- Family Medicine Physician
- Lagrange, IN
National Provider Identifier
1972728202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01037748A
- Practice address
- 2120 N Detroit St
Lagrange, IN 46761-1147 - Phone
- (260) 463-2468
- Fax
- (260) 463-4237
- NPI assigned
- Apr 13, 2007
- Last updated
- Jul 27, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01037748A | IN | Primary |
Addresses
Primary practice location
2120 N Detroit St
Lagrange, IN 46761-1147
Mailing address
2120 N Detroit St
Lagrange, IN 46761-1147
Phone (260) 463-2468
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8757 | Other | IN | PHP |
| 000000299462 | Other | IN | ANTHEM BCBS |
| 100159830A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2120 N Detroit St
La Grange, IN 46761-1147
Phone (260) 463-2468
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 15 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redi-Care Inc P C | Current | Accepting new patients |
Locations
2120 N Detroit St
Lagrange, IN 46761
Phone (260) 463-2468
Interoperability endpoints
- dhershberger3693@direct.parkviewexchange.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Redi-Care Inc P C | Rural health clinic | 5% Or Greater Direct Ownership Interest Corporate Director |
Jan 1, 2003 Jun 10, 2004 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Lagrange, IN
- NPI 1790896611
5% Or Greater Direct Ownership Interest, Corporate Director
Organizations & group practices 1
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.
-
- Rural Health Clinic/Center
- Lagrange, IN
- NPI 1790896611
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Parkview LaGrange Hospital
- Critical Access Hospital
- Lagrange, IN
- NPI 1679674956
-
- General Acute Care Hospital
- Goshen, IN
- NPI 1740268846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1972728202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 N DETROIT ST",
"city": "LAGRANGE",
"state": "IN",
"postal_code": "467611147",
"telephone_number": "260-463-2468",
"fax_number": "260-463-4237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 N DETROIT ST",
"city": "LAGRANGE",
"state": "IN",
"postal_code": "467611147",
"telephone_number": "260-463-2468",
"fax_number": "260-463-4237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSHBERGER",
"first_name": "DARYL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01037748A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "8757",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000299462",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100159830A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.