Individual provider Active NPI

Sherri King

  • Health Educator
  • Salem, OR
National Provider Identifier
1043750367
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
W50131 Issued in FL
Practice address
4696 Reimann St NE
Salem, OR 97305
Phone
(352) 220-3057
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 17987 FL
Health Educator 174H00000X W50131 FL Primary

Addresses

Primary practice location

4696 Reimann St NE
Salem, OR 97305

Mailing address

4696 Reimann St NE
Salem, OR 97305-2252
Phone (352) 220-3057

Other practice location 1

208 Daisy Ln
Inverness, FL 34452-5754
Phone (352) 220-3057

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
W50131FLMDHealth Educator
17987FLMDMusic Therapist

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1043750367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 REIMANN ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973052252",
            "telephone_number": "352-220-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 REIMANN ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97305",
            "telephone_number": "352-220-3057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Daisy Ln",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344525754",
            "country_code": "US",
            "telephone_number": "352-220-3057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "SHERRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "17987",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "FL",
            "license": "W50131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.