Individual provider Active NPI

John E Shero, CPED

  • Specialist
  • Wichita, KS
National Provider Identifier
1013145804
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
66 Issued in OK
Practice address
135 N Main St
Wichita, KS 67202
Phone
(866) 997-3425
NPI assigned
Jun 30, 2009
Last updated
Jul 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 66 OK Primary

Addresses

Primary practice location

135 N Main St
Wichita, KS 67202

Mailing address

1205 Medical Plaza CT
Granbury, TX 76048-5684
Phone (178) 900-2250

Other practice location 1

135 N Main St
Wichita, KS 67202-1400
Phone (866) 997-3425

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

LicenseStateTypeSpecialty
66OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bearfoot Shoes, LLC Current Accepting new patients
Regal Medical Supply, LLC Past Accepting new patients

Locations

1205 Medical Plaza Ct
Granbury, TX 76048
Phone (817) 573-4123

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1013145804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 MEDICAL PLAZA CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485684",
            "telephone_number": "178-900-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67202",
            "telephone_number": "866-997-3425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 N Main St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672021400",
            "country_code": "US",
            "telephone_number": "866-997-3425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERO",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CPED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "66",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.