Sherryl J. Tomboulian, M.D., P.H.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9632 Issued in SD

Practice address

205 Orchard Dr
Sisseton, SD 57262-2312

Phone

(605) 698-7681

Fax

(605) 698-3493

NPI assigned

Jul 6, 2006

Last updated

Jul 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sherryltomboulian@tdh.allscriptsdirect.net
• Direct secure messaging: sjtomboulian@direct.nshcorp.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232

  Family Medicine

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041
  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nome, AK
  • NPI 1427187046
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1003847971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622312",
            "telephone_number": "605-698-7681",
            "fax_number": "605-698-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622312",
            "telephone_number": "605-698-7681",
            "fax_number": "605-698-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBOULIAN",
        "first_name": "SHERRYL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D., P.H.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A73423",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "49138",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "9632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47480777",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tekakwitha Nursing Center Inc (Tekakwitha Living Center)
• Leah Meyer Thielen, DC
• Paul William Thielen, BS DC
• Mary Jo Thoennes, RPH
• Nathan Tiedeman, DNP, FNP, RN
• US Dept of Health & Human Services
• Jodie Webb, FNP-BC
• Leah Adele Weiss, PHARMD
• Dana Marie Wilson, RN
• Elijah John Wolfe, RT

• Family Medicine Physician in Sisseton, SD
• Providers in Sisseton, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.