Individual provider Active NPI

Thomas E Sherry, M.D.

  • Family Medicine Physician
  • Polson, MT
National Provider Identifier
1134561806
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49747 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860-5315
Phone
(406) 883-5680
Fax
(406) 883-8910
NPI assigned
Jul 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49747 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860-5315

Mailing address

PO Box 262
Liberty Lake, WA 99019-0262
Phone (406) 258-4789

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tsherry309182@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729009854 MT Practitioner - Emergency Medicine 5294049623 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49747MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC CurrentSince Jul 1, 2015 Accepting new patients
Associates for Inpatient Medicine, LLC Past Accepting new patients

Locations

1600 Hospital Way
Whitefish, MT 59937
Phone (406) 863-3500

Interoperability endpoints

  • Direct secure messaging: thomas.sherry@437666684469252.direct.elationemr.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1134561806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190262",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "49747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsherry309182@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "6 13th Ave E",
            "city": "Polson",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598605315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.