Active NPI
Derrick Clinton Herron, PHARM.D
- Pharmacist
- Manchester, KY
National Provider Identifier
1992203004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 017973
- Practice address
- 210 Marie Langdon Dr
Manchester, KY 40962-6388 - Phone
- (606) 598-5104
- Fax
- (606) 598-4509
- NPI assigned
- Jan 24, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017973 | KY | Primary |
Addresses
Primary practice location
210 Marie Langdon Dr
Manchester, KY 40962-6388
Mailing address
210 Marie Langdon Dr
C/O: Pharmacy
Manchester, KY 40962-6388
Phone (606) 598-5104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017973 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1992203004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 MARIE LANGDON DR",
"address_2": "C/O: PHARMACY",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626388",
"telephone_number": "606-598-5104",
"fax_number": "606-598-4509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MARIE LANGDON DR",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626388",
"telephone_number": "606-598-5104",
"fax_number": "606-598-4509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRON",
"first_name": "DERRICK",
"middle_name": "CLINTON",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-24",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "017973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.