Individual provider Active NPI

Martha Ann B Sharkey, MD

  • Pediatrics Physician
  • Rogers, AR
National Provider Identifier
1104810126
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E2002 Issued in AR
Practice address
5507 Walsh LN
Suite 101
Rogers, AR 72758-8941
Phone
(479) 464-8231
Fax
(479) 464-8230
NPI assigned
Sep 6, 2005
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E2002 AR Primary

Addresses

Primary practice location

5507 Walsh LN
Suite 101
Rogers, AR 72758-8941

Mailing address

3360 E Carmel LN
Fayetteville, AR 72701-2834
Phone (479) 582-0719

Other identifiers 1

IdentifierTypeStateIssuer
135776001MedicaidAR

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E2002ARMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1104810126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 E CARMEL LN",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727012834",
            "telephone_number": "479-582-0719",
            "fax_number": "479-464-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5507 WALSH LN",
            "address_2": "SUITE 101",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588941",
            "telephone_number": "479-464-8231",
            "fax_number": "479-464-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARKEY",
        "first_name": "MARTHA ANN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E2002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135776001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.

Verify at the official NPI Registry.