PAUL J. HERGENROEDER, M.D., LTD (NPI# 1124171293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124171293 |
| Entity Type | Organization |
| Organization Name | PAUL J. HERGENROEDER, M.D., LTD |
| Practice Address |
2000 Mclain St Newport AR 72112-3661 |
| Mailing Address |
Po Box 39 Newport AR 72112-0039 |
| Practice Telephone | 8705236728 |
| Mailing Telephone | 8705236728 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PAUL JOHN HERGENROEDER (PRESIDENT) |
| Authorized Official Telephone | 8705236728 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | N7174 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUECROSSBLUESHIELD | 5B232 | 01 |
| Street Address |
2000 MCLAIN ST |
| City | NEWPORT |
| State | AR |
| Zip Code | 72112-3661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306835756 | Randall E Hunt | Family Medicine | 2000 Mclain St, Suite 2b, Newport, AR 72112-3661 | 2005-10-18 |
| 1417421561 | Lhcg Cxxxxii, LLC | Home Health | 2000 Mclain St, Newport, AR 72112-3661 | 2019-01-11 |
| 1245680321 | Kerry Hanna | Nurse Practitioner | 2000 Mclain St, Newport, AR 72112-3661 | 2016-06-20 |
| 1154588762 | Samuel Selasie Mortoti | Internal Medicine | 2000 Mclain St, Suite H, Newport, AR 72112-3661 | 2008-05-21 |
| 1073636551 | Wade Falwell, M.d.,p.a. | Clinic/Center | 2000 Mclain St, Suite G, Newport, AR 72112-3661 | 2007-04-09 |
| 1972615730 | Archie Del Mundo Cachola | Pediatrics | 2000 Mclain St, Suite F, Newport, AR 72112-3661 | 2006-08-31 |
| 1639111347 | Newport Hospital Durable Medical Equipment | Durable Medical Equipment & Medical Supplies | 2000 Mclain St, Newport, AR 72112-3661 | 2006-06-10 |
| 1477509008 | Melvin Nance | Family Medicine | 2000 Mclain St, Newport, AR 72112-3661 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447749437 | Amie Burrow | Nurse Practitioner | 300 Corrections Drive, Newport, AR 72112 | 2018-05-04 |
| 1780120691 | Rx Hound Inc | Pharmacy | 1117 Mclain St Ste 400, Newport, AR 72112 | 2017-01-17 |
| 1285188789 | Jasmine Mansko | Speech-Language Pathologist | 1128 S Main St, Newport, AR 72112 | 2016-08-12 |
| 1366831877 | Madison Eddington | Physical Therapy Assistant | 1807 Jetta Drive, Newport, AR 72112 | 2015-01-21 |
| 1750514840 | Ralph Irwin Wray | Counselor | 107 Laurel St, Newport, AR 72112 | 2009-08-24 |
| 1952558264 | Maxus Inc | Counselor | 2000 Mclain, Suite B, Newport, AR 72112 | 2008-08-19 |
| 1275748725 | Troy Larry Vincent Sr. | Counselor | 1507 N. Pecan St., Newport, AR 72112 | 2007-05-10 |
| 1114065083 | Deanna Dawn Browning | Case Manager/Care Coordinator | 1509 N Pecan St, Newport, AR 72112 | 2007-02-02 |
| 1295895670 | Allene Cummings | Social Worker | 1507 North Pecan Street, Newport, AR 72112 | 2006-12-08 |
| 1295801207 | Brandy Diane Young | Speech-Language Pathologist | 221 Lindley Lane, Newport, AR 72112 | 2006-11-28 |
| Find all providers in zip 72112 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063036101 | Integrity Women's Health & Wellness, LLC | Obstetrics & Gynecology | 594 Se Running Springs, Newport, OR 97365 | 2020-06-04 |
| 1336283563 | Ian Ross Donald | Obstetrics & Gynecology | 775 Sw 9th St Ste H, Newport, OR 97365-4876 | 2007-02-19 |
| 1487749768 | Martha Higginbotham Aldridge | Obstetrics & Gynecology | 19 Friendship Street, Suite 200, Newport, RI 02840 | 2006-10-04 |
| 1649364498 | Jennifer Lynn Brenton | Obstetrics & Gynecology | 19 Friendship St Unit 220, Newport, RI 02840-2264 | 2006-10-03 |
| 1235171182 | Daniel Duane Kort | Obstetrics & Gynecology | 130 Nw 19th St., Suite A, Newport, OR 97364 | 2006-06-12 |
| 1982644282 | John Robert Wichert | Obstetrics & Gynecology | 775 Sw Ninth Street, Suite H, Newport, OR 97365-4876 | 2006-06-07 |
| 1801866900 | Jabez Fenton Jackson Jr. | Obstetrics & Gynecology | 1201 Mclain St, Newport, AR 72112-3533 | 2006-01-23 |
| 1174525091 | Carrie Lynn Johnson | Obstetrics & Gynecology | 930 Sw Abbey St Ste B, Newport, OR 97365-4820 | 2005-08-11 |
| 1740280072 | Jonathan Kale Gavin Shumate | Obstetrics & Gynecology | 1010 Sw Coast Hwy Ste 102, Newport, OR 97365-5239 | 2005-07-28 |
| 1104463322 | Cocke County Hma LLC | Obstetrics & Gynecology | 434 4th St Ste 305, Newport, TN 37821-3735 | 2019-12-06 |
| Find all providers in NEWPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.