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Deactivated NPI 1598841413 Deactivated / Inactive NPI Male Practitioner

Jerry Herzog , PA

Physician Assistant • Chardon, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jerry Herzog has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 31, 2006
NPI Deactivation Date June 23, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Jerry Herzog, PA was a registered Physician Assistant practicing in Chardon, OH. Throughout an active medical career spanning 16 years, Jerry Herzog provided care at the practice location at 13207 RAVENNA RD until profile deactivation on 2022-06-23.

Practice Location & Contact Primary Location

Practice Address

13207 Ravenna Rd

Chardon, OH 440247032

Telephone 4402856000
Fax 3306565901
Associated Practice Facility / Clinic
🏢 Geauga Sports Medicine, Llc Facility NPI 1396746970

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Chardon, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 6.8 Yrs
State Avg: 9.7 Yrs
Regional Practice Density
14 Specialists

Practicing in Chardon, OH (5376 Statewide)

Telehealth Adoption Rate
21.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OH 50000857

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Robert Zimmerman , MD

Emergency Medicine

NPI 1023093960

Doctor of Medicine (M.D.)

NPI 1023738341

Doctor of Pharmacy (Pharm.D.)

Dr. Lavanya Gali , MD

Student in an Organized Health Care Education/Training Program

NPI 1023849213

Doctor of Medicine (M.D.)

Dr. David Jackson , MD

Emergency Medicine

NPI 1033195607

Doctor of Medicine (M.D.)

Annamarie Salvador , CNP

Nurse Practitioner

NPI 1043906332

Certified Nurse Practitioner

Dr. Suhani Dalal , MD

Student in an Organized Health Care Education/Training Program

NPI 1053052241

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 23, 2022

Record deactivated on June 23, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 13207 RAVENNA RD, CHARDON, OH 440247032 (Tel: 4402856000)

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Updated Business Mailing Address July 08, 2007

Registered at 5700 DARROW RD, SUITE 106, HUDSON, OH 442365021 (Tel: 3306565911)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JERRY HERZOG, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #50000857 in OH)

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Initial NPI Registration & Enumeration October 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598841413
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 31, 2006
Last Update: July 08, 2007
Deactivation Date: June 23, 2022

Mailing Address

5700 Darrow Rd, Suite 106

Hudson, OH 442365021

Phone: 3306565911

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.