James K Sheronick, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6279 Issued in IA

Practice address

201 1St Ave.
Van Horne, IA 52346

Phone

(319) 228-8404

Fax

(319) 228-8659

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124053004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "VAN HORNE",
            "state": "IA",
            "postal_code": "523460097",
            "telephone_number": "319-228-8404",
            "fax_number": "319-228-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 1ST AVE.",
            "city": "VAN HORNE",
            "state": "IA",
            "postal_code": "52346",
            "telephone_number": "319-228-8404",
            "fax_number": "319-228-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERONICK",
        "first_name": "JAMES",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142406",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benton Community School
• Mary Hoefle
• Bethany Lea Hoopes, PHARMD.
• Elizabeth Mae Stout
• Rita Jean Taylor-Stewart, PA-C
• Virginia Gay Hospital, Inc

• All providers in Van Horne, IA
• General Practice Dentistry in Iowa

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.