Healthcare Provider Details

I. General information

NPI: 1245200252
Provider Name (Legal Business Name): JEFFREY B. HERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 MAIN ST STE 200
KANSAS CITY MO
64112-2582
US

IV. Provider business mailing address

6650 W 110TH ST STE 200
OVERLAND PARK KS
66211-1545
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-9989
  • Fax: 816-444-9957
Mailing address:
  • Phone: 913-319-8400
  • Fax: 913-696-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number04-28772
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2000161124
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2000161124
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: