Kevin Sheridan, OT

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

OT-2766 Issued in OH

Practice address

18160 County Road 54
Warsaw, OH 43844-9006

Phone

(740) 601-1639

NPI assigned

Nov 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Legacy Healthcare Services, Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1336535988

  FL

  Medicare reassignment

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1043975121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18160 COUNTY ROAD 54",
            "city": "WARSAW",
            "state": "OH",
            "postal_code": "438449006",
            "telephone_number": "740-601-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18160 COUNTY ROAD 54",
            "city": "WARSAW",
            "state": "OH",
            "postal_code": "438449006",
            "telephone_number": "740-601-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "OH",
            "license": "OT-2766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kevin.sheridan68@yahoo.com",
            "affiliation": "N",
            "address_1": "18160 County Road 54",
            "city": "Warsaw",
            "state": "OH",
            "country_code": "US",
            "postal_code": "438449006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruby J Miller
• Sherry Kay Myers, LPN
• Prime Healthcare Foundation - Coshocton LLC
• River View Local School District
• Lisa Sheer, IBCLC
• Dale Smith
• Melissa Thompson-Mobley, LPN
• Kim Trull
• Jennifer Lee Tucker
• Nikole Werntz, SLP

• All providers in Warsaw, OH
• Gerontology Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.