Individual provider Active NPI

Wilfredo Nicolas Herrera, MD

  • Obstetrics & Gynecology Physician
  • Knoxville, TN
National Provider Identifier
1992140677
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
64203 Issued in TN
Practice address
501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone
(865) 331-2020
Fax
(865) 331-1976
NPI assigned
May 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME133051 FL
Obstetrics & Gynecology Physician 207V00000X 64203 TN Primary

Addresses

Primary practice location

501 19TH St Ste 401
Knoxville, TN 37916-1831

Mailing address

501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone (865) 331-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210903002381 TN Practitioner - Obstetrics/Gynecology 2961776133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Florida College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Sanders Perinatal CenterGroup PAC ID 3577505536, 34 clinicians

Practice addresses (Care Compare)

501 19TH St
Suite 401
Knoxville, TN 37916-1831
Phone (865) 541-2020

Hospital & facility affiliations

  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME133051FLMDObstetrics & Gynecology Physician
64203TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Perinatal Center CurrentSince Oct 11, 2021 Accepting new patients

Locations

8035 Roane Medical Center Dr
Ste 250
Harriman, TN 37748
Phone (865) 316-9636

7625 Chapman Hwy
Ste 103
Knoxville, TN 37920
Phone (865) 331-1122

501 19th St
Ste 401
Knoxville, TN 37916
Phone (865) 331-2020

Dept 888247
Knoxville, TN 37995

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1992140677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020",
            "fax_number": "865-331-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020",
            "fax_number": "865-331-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "WILFREDO",
        "middle_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME133051",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "64203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.