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JOSHUA BRENT HERNDON
NPI 1194354266
Internal Medicine in Summerville, GA

Active since April 02, 2020PECOS EnrolledAccepts Medicare Assignment
98.1/100
CMS Quality Rating
11766 HIGHWAY 27, SUMMERVILLE, GA 30747(706) 857-3915 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 5, 2023, Apr 2, 2020 (2 updates tracked since 2020).

About Joshua Brent Herndon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSHUA BRENT HERNDON (NPI 1194354266) is an individual internal medicine provider in Summerville, Georgia, licensed in Georgia (95722) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Floyd Medical Center, and is a graduate of Mercer University School Of Medicine (2020).

NPPES Registry Identity

NPI1194354266
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJOSHUA BRENT HERNDON
Location Address11766 HIGHWAY 27Summerville, GA 30747-5989
Mailing Address420 E 2nd Ave Ste 103Rome, GA 30161-3210 · (706) 509-3000
Phone(706) 857-3915
Sole ProprietorNo
Medical School CMSMercer University School Of MedicineGraduated 2020
Enumeration DateApril 2, 2020
Last NPPES UpdateSeptember 5, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2023
✔ NPI 1194354266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 95722
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
11766 HIGHWAY 27, Summerville, GA 30747
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joshua Brent Herndon 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.

PECOS PAC ID9133546344
PECOS Enrollment IDI20230719001909
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
274 services105 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
178 services95 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
49 services49 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
22 services22 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
21 services21 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
21 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Atrium Health Floyd Medical Center

Acute Care Hospitals · Rome, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110054
Location304 Turner Mccall BoulevardRome, GA 30162 · Floyd County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30747 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

98.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability96
Improvement Activities40

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLIE CRUMP
Nurse Practitioner (Family)
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (706) 857-1010
JOEL K. JAGER M.D.
Family Medicine
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (706) 857-1010
MATTHEW THOMAS CORNFORTH M.D.
Family Medicine
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (706) 857-1010
DR. NAOMI SAFIYA BROWN MD
Family Medicine
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (770) 968-6460
MS. PAMELA B HELMS FNP
Nurse Practitioner (Family)
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (706) 857-3915
MR. BRUCE WYNN PA-C
Physician Assistant
11766 HIGHWAY 27, SUITE A
SUMMERVILLE, GA 30747
Chattooga County (706) 734-2878
FLOYD HEALTHCARE MANAGEMENT, INC
Non-Pharmacy Dispensing Site
11766 HIGHWAY 27
SUMMERVILLE, GA 30747
Chattooga County (706) 857-1010

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 Joshua Herndon's NPI number?

The NPI number for Joshua Herndon is 1194354266. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Where is Joshua Herndon located?

Joshua Herndon practices at 11766 Highway 27, Summerville, GA 30747. The listed phone number is (706) 857-3915.

What is Joshua Herndon's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Joshua Herndon enrolled in Medicare?

Yes. Joshua Herndon 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.

What insurance does Joshua Herndon accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Joshua Herndon 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 Joshua Herndon affiliated with any hospitals?

According to CMS data, Joshua Herndon is affiliated with Atrium Health Floyd Medical Center.

When was this NPI record last updated?

The NPPES record for Joshua Herndon was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.