Active NPI
Sheila Richard, CST, CSFA
- Surgical Physician Assistant
- Sebastian, FL
National Provider Identifier
1003443904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 981 Tarpon Ave
Sebastian, FL 32958-5147 - Phone
- (321) 508-8756
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 138914 | FL | |
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
981 Tarpon Ave
Sebastian, FL 32958-5147
Mailing address
PO Box 780642
Sebastian, FL 32978-0642
Phone (321) 508-8756
Other practice location 1
Cleveland Clinic Indian River Hospital
1000 36th St
Vero Beach, FL 32960
Phone (772) 567-4311
Other practice location 2
13695 US Highway 1
Sebastian, FL 32958-3230
Phone (772) 589-3186 ext. 2080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138914 | Other | FL | THE NATIONAL BOARD OF SURGICAL TECHNOLOGIST AND SURGICAL ASSISTING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138914 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620432000000",
"number": "1003443904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 780642",
"city": "SEBASTIAN",
"state": "FL",
"postal_code": "329780642",
"telephone_number": "321-508-8756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "981 TARPON AVE",
"city": "SEBASTIAN",
"state": "FL",
"postal_code": "329585147",
"telephone_number": "321-508-8756"
}
],
"practiceLocations": [
{
"address_1": "Cleveland Clinic Indian River Hospital",
"address_2": "1000 36th St",
"address_purpose": "LOCATION",
"city": "Vero Beach",
"state": "FL",
"postal_code": "32960",
"country_code": "US",
"telephone_number": "772-567-4311",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13695 US Highway 1",
"address_purpose": "LOCATION",
"city": "Sebastian",
"state": "FL",
"postal_code": "329583230",
"country_code": "US",
"telephone_number": "772-589-3186 x2080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHARD",
"first_name": "SHEILA",
"credential": "CST, CSFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-23",
"last_updated": "2021-05-08",
"certification_date": "2021-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "138914",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE NATIONAL BOARD OF SURGICAL TECHNOLOGIST AND SURGICAL ASSISTING",
"identifier": "138914",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sebastian, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.