Individual provider Active NPI

Canaan S. Herrygers, M.D.

  • Pediatrics Physician
  • Wesley Chapel, FL
National Provider Identifier
1972828499
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 116171 Issued in FL
Practice address
5259 Village Market
Wesley Chapel, FL 33544-8401
Phone
(813) 973-0333
Fax
(813) 973-0333
NPI assigned
Mar 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 116171 FL Primary

Addresses

Primary practice location

5259 Village Market
Wesley Chapel, FL 33544-8401

Mailing address

4033 Tampa Rd Ste 101
Oldsmar, FL 34677-3224
Phone (813) 854-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130808000497 FL Practitioner - Pediatric Medicine 4385886068 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 116171FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Jul 15, 2013 Accepting new patients
MCR Health, Inc. CurrentSince Jul 15, 2013 Accepting new patients
Pediatric Health Care Alliance, PA Pediatrics PastSince Aug 28, 2021 Accepting new patients
Pediatric Health Care Alliance, PA Pediatrics Past Accepting new patients

Locations

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1972828499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TAMPA RD STE 101",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773224",
            "telephone_number": "813-854-2003",
            "fax_number": "813-855-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5259 VILLAGE MARKET",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448401",
            "telephone_number": "813-973-0333",
            "fax_number": "813-973-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRYGERS",
        "first_name": "CANAAN",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 116171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.