Active NPI
Sherry Lea Dutton
- Other Technician
- Flagstaff, AZ
National Provider Identifier
1073806485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- D04796676
- Practice address
- 3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972 - Phone
- (928) 255-4718
- NPI assigned
- May 17, 2011
- Last updated
- May 17, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | D04796676 | AZ | Primary |
Addresses
Primary practice location
3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972
Mailing address
711 N Diabase Way
Flagstaff, AZ 86001-3348
Phone (928) 300-6294
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
| License | State | Type | Specialty |
|---|---|---|---|
| D04796676 | AZ | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1073806485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 N DIABASE WAY",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013348",
"telephone_number": "928-300-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 N WINDING BROOK RD",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860010972",
"telephone_number": "928-255-4718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTTON",
"first_name": "SHERRY",
"middle_name": "LEA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-17",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "AZ",
"license": "D04796676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.