Active NPI
Leeanne B Sherwin, MS, APRN-BC
- Nurse Practitioner
- Idaho Falls, ID
National Provider Identifier
1043279771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP587
- Practice address
- 2770 Cortez Ave
Idaho Falls, ID 83404-7590 - Phone
- (208) 522-4000
- Fax
- (208) 528-4242
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | N31764 | ID | |
| Nurse Practitioner | 363L00000X | NP587 | ID | Primary |
Addresses
Primary practice location
2770 Cortez Ave
Idaho Falls, ID 83404-7590
Mailing address
2770 Cortez Ave
Idaho Falls, ID 83404-7590
Phone (208) 522-4000
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
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N31764 | ID | MD | Nurse Practitioner |
| NP587 | ID | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043279771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2770 CORTEZ AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047590",
"telephone_number": "208-522-4000",
"fax_number": "208-528-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2770 CORTEZ AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047590",
"telephone_number": "208-522-4000",
"fax_number": "208-528-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERWIN",
"first_name": "LEEANNE",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "MS, APRN-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "N31764",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "NP587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.