DR. MARK DAVID HERNDON (NPI# 1285751107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285751107 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID HERNDON |
| Credential | MD |
| Practice Address |
1012 Medical Ridge Rd Clinton SC 29325-4542 |
| Mailing Address |
218 Falls Rd Toccoa GA 30577-1631 |
| Practice Telephone | 8648223852 |
| Practice Fax Number | 8649380501 |
| Mailing Telephone | 7062977877 |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2019-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 32321 | SC | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 58753 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | FH1174046 | 01 | |
| GA | STATE LICENSE NUMBER | 58753 | 01 |
| SC | STATE OF SC | 32321 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790118289 | Mark A Herndon | Orthotic Fitter | 3845 Hendersonville Rd, Fletcher, NC 28732-8241 | 2013-08-20 |
| Street Address |
1012 MEDICAL RIDGE RD |
| City | CLINTON |
| State | SC |
| Zip Code | 29325-4542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774752 | Rufus W Watkins | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2005-07-20 |
| 1619479342 | Upstate Podiatry Group, Pa | Clinic/Center | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2018-03-08 |
| 1336439314 | Lchcs Dba Wilson and Mccormack Surgical Services | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2011-04-12 |
| 1447213079 | Raymond Michael Wiggins | Specialist | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2006-04-06 |
| 1609844653 | Samuel Mayhew Wilson | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2006-03-08 |
| 1710970520 | Carter Jameson Mccormack | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2005-08-26 |
| 1578564688 | Bruce A Marshall | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353100 | Mason Paige Gambrell | Student in an Organized Health Care Education/Training Program | 107 Shellcreek Ct, Clinton, SC 29325 | 2020-07-07 |
| 1386207975 | Tammy Binger | Registered Nurse | 22725 U.S. 76, Clinton, SC 29325 | 2019-04-18 |
| 1154828945 | Lillian Smith | Physical Therapy Assistant | Nhc Clinton, 304 Jacobs Highway, Clinton, SC 29325 | 2018-04-09 |
| 1134519366 | Nora Pace | Specialist/Technologist | 18132 Hwy 72 E, Clinton, SC 29325 | 2015-01-26 |
| 1497186845 | John M. Griz | Orthopaedic Surgery | 22971 Hwy 76e, Clinton, SC 29325 | 2013-12-11 |
| 1992131171 | Sharon Kay Stoia | Occupational Therapist | 600 Plaza Circle, Clinton, SC 29325 | 2013-09-19 |
| 1578800256 | Hayes Ambulance Service LLC | Ambulance | 2143 Torrington Road, Clinton, SC 29325 | 2013-01-14 |
| 1083943518 | Margaret Estelle Shreve | Chiropractor | 209 Musgrove St, Clinton, SC 29325 | 2009-12-11 |
| 1750556213 | Piedmont Regional Urology | Urology | 300 Plantation Plaza, Suite F, Clinton, SC 29325 | 2008-04-25 |
| 1285821587 | Assisted Living Concepts Inc | Assisted Living Facility | 939 Springdale Drive, Clinton, SC 29325 | 2007-10-01 |
| Find all providers in zip 29325 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205247970 | Clinton Surgical Pllc | Surgery | 603 Beaman St Ste 200, Clinton, NC 28328-2647 | 2014-05-15 |
| 1760744361 | Sampson Regional Professional Services, LLC | Surgery | 607 Beaman Street, Clinton, NC 28328-2603 | 2012-06-11 |
| 1306059845 | Jan Bristow Newman | Surgery | 3436 Mountain Dr, Clinton, MT 59825-9750 | 2007-05-08 |
| 1538114186 | Steve Palmer Schoettle | Surgery | 2526 Hwy 65 South, Suite 205, Clinton, AR 72031 | 2006-05-23 |
| 1275596017 | Michael Arthur Valenti | Surgery | 603 Beaman Street, Suite 200, Clinton, NC 28328-2647 | 2006-04-11 |
| 1073580122 | Sidney P Rohrscheib | Surgery | 803 Illini Dr, Clinton, IL 61727-9444 | 2006-03-07 |
| 1699774752 | Rufus W Watkins | Surgery | 1012 Medical Ridge Rd, Clinton, SC 29325-4542 | 2005-07-20 |
| 1063880599 | Medstar Southern Maryland Physicians, LLC | Surgery | 7501 Surratts Rd, Suite 208, Clinton, MD 20735-3362 | 2015-09-15 |
| 1871903054 | Medstar Southern Maryland Physicians, LLC | Surgery | 7501 Surratts Rd, Suite 305, Clinton, MD 20735-3362 | 2014-04-28 |
| 1205259298 | Sampson Regional Professional Services, LLC | Surgery | 607 Beaman St, Clinton, NC 28328-2603 | 2014-01-27 |
| Find all providers in CLINTON | ||||
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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.