JOHNATHON R HERRON (NPI# 1639736432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639736432 |
| Entity Type | Individual |
| Full Name | JOHNATHON R HERRON |
| Credential | CSFA, CST |
| Practice Address |
4500 13th St Gulfport MS 39501-2515 |
| Mailing Address |
18339 Tiffany Renee Dr Gulfport MS 39503-7550 |
| Practice Telephone | 2288674000 |
| Mailing Telephone | 2288618891 |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487027504 | Advanced Surgical Assistants LLC | Physician Assistant | 1924 30th Ave Ste A, Gulfport, MS 39501-4534 | 2015-11-11 |
| 1326478744 | William Bishop | Physician Assistant | 11476 Savannah Pl, Gulfport, MS 39503-1109 | 2013-11-21 |
| 1376840173 | Christopher Lawrence Sweebe | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-02-15 |
| 1528275633 | Tina M Mcginty | Physician Assistant | 250 Church Ave, Gulfport, MS 39507-1255 | 2007-05-17 |
| 1245613694 | John Miyakawa | Physician Assistant | 12337 Ashley Dr, Suite F, Gulfport, MS 39503-2753 | 2015-07-02 |
| 1366864811 | Latricia Rochelle Allen | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2014-01-16 |
| 1851688618 | Precision Surgical Resources | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-06-30 |
| 1588829048 | Darrell Bernard Colliers | Physician Assistant | 15200 Community Rd, Gulfport, MS 39523 | 2008-07-24 |
| 1033208889 | Randall W Chang | Physician Assistant | 1340 Broad Ave, Suite 420, Gulfport, MS 39501-2404 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1114392172 | Robin Rae Hoffeld | Physician Assistant | 11401 Wedgewood Ln, Ocean Springs, MS 39564-7910 | 2015-12-02 |
| 1063889509 | Julie Dianne Sullivan | Physician Assistant | 216 Linda Dr, Ocean Springs, MS 39564-4114 | 2015-09-01 |
| 1922190271 | Robert L. Gillum Jr. | Physician Assistant | 6099 Adaughtery Rd, Suite A, Long Beach, MS 39560 | 2006-09-28 |
| 1841249489 | Bradley Martin | Physician Assistant | 1014 Biglane Drive, Brookhaven, MS 39601 | 2006-05-10 |
| 1144293655 | David Bradley Robbins | Physician Assistant | 206 Oxford Rd, New Albany, MS 38652-3115 | 2006-02-07 |
| 1801877022 | Benjamin P Watts | Physician Assistant | 3615 Hospital St, Pascagoula, MS 39581-4112 | 2005-11-07 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1275163727 | Kaitlin Lehto | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 | 2020-01-23 |
| 1154951739 | Hailey Daniels Kelly | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-22 |
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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.