Individual provider Active NPI

Sheryl Marie Bartholow, FNP

  • Family Nurse Practitioner
  • Glencoe, MN
National Provider Identifier
1003800517
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R105634-1 Issued in MN
Practice address
1805 Hennepin Ave N
Glencoe, MN 55336
Phone
(320) 864-3121
Fax
(320) 864-7887
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R1056341 MN
Family Nurse Practitioner 363LF0000X R105634-1 MN Primary

Addresses

Primary practice location

1805 Hennepin Ave N
Glencoe, MN 55336

Mailing address

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

Other names 1

  • Sheryl Marie Reese Former name

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R105634-1MNMDFamily Nurse Practitioner
R1056341MNMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1003800517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOW",
        "first_name": "SHERYL",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1056341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R105634-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERYL",
            "last_name": "REESE",
            "middle_name": "MARIE",
            "credential": "MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glencoe, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.