DR. CARLTON WAYNE HERALD DO
NPI 1053302836
Internal Medicine in Gallipolis, OH
About Dr. Carlton Wayne Herald Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CARLTON WAYNE HERALD DO (NPI 1053302836) is an individual internal medicine provider in Gallipolis, Ohio, licensed in Ohio (34.007166) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Holzer Medical Center, and maintains a secondary practice location in Kermit.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Carlton Wayne Herald Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Carlton Herald reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Gallipolis, OH 45631
- Reassigned Medicare billing, Ohio enrollment
- 321 clinicians in this Medicare group
Logan, WV 25601
- Reassigned Medicare billing, West Virginia enrollment
- 113 clinicians in this Medicare group
Columbus, OH 43213
- Reassigned Medicare billing, Ohio enrollment
- 3,314 clinicians in this Medicare group
Beckley, WV 25801
- Reassigned Medicare billing, West Virginia enrollment
- 183 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Holzer Medical Center
Acute Care Hospitals · Gallipolis, OHHolzer Medical Center Jackson
Critical Access Hospitals · Jackson, OHPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45631 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GALLIPOLIS, OH 45631
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carlton Herald's NPI number?
The NPI number for Carlton Herald is 1053302836. It was assigned to this individual provider in the NPPES registry on November 2, 2005.
Where is Carlton Herald located?
Carlton Herald practices at 100 Jackson Pike, Gallipolis, OH 45631. The listed phone number is (740) 446-5533.
What is Carlton Herald's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Carlton Herald enrolled in Medicare?
Yes. Carlton Herald is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Carlton Herald's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carlton Herald reassigns Medicare benefits to 4 organizations: Holzer Clinic, LLC (Gallipolis, OH), Apogee Medical Group, West Virginia, PLLC (Logan, WV), Ohiohealth Corporation (Columbus, OH) and Health Care Alliance, Inc. (Beckley, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carlton Herald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Carlton Herald accept?
Health plans from Antidote Health Plan of Ohio, Inc. and CareSource list Carlton Herald as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Carlton Herald affiliated with any hospitals?
According to CMS data, Carlton Herald is affiliated with Holzer Medical Center and Holzer Medical Center Jackson.
When was this NPI record last updated?
The NPPES record for Carlton Herald was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Carlton Wayne Herald, DO · NPI 1053302836
Internal Medicine physician in Gallipolis, Ohio. Individual provider, active in the CMS NPPES registry since November 2, 2005.
## Identity
- **NPI:** 1053302836 (Entity type: Individual)
- **Enumerated:** November 2, 2005
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 34.007166 (Ohio)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 JACKSON PIKE, Gallipolis, OH 45631-1560
- **Phone:** (740) 446-5533 · **Fax:** (740) 441-3318
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Holzer Clinic, LLC (NPI 1508817248, Gallipolis, OH); Apogee Medical Group, West Virginia, PLLC (NPI 1669708442, Logan, WV); Ohiohealth Corporation (NPI 1265627301, Columbus, OH); Health Care Alliance, Inc. (NPI 1730128760, Beckley, WV) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** West Virginia School Of Osteopathic Medicine, class of 1998
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Medicaid 2168890 (OH); Medicaid 64071467 (KY); Other 00427029 (WV); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1053302836) · Data from the CMS NPPES public registry.