Individual provider Active NPI

Sheree Lynn Slack, NP-C

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1154968279
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRNCNP1018576 Issued in TX
Practice address
8588 Katy Fwy Ste 226a
Houston, TX 77024-1881
Phone
(713) 532-6884
Fax
(713) 532-5756
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRNCNP1018576 TX Primary

Addresses

Primary practice location

8588 Katy Fwy Ste 226a
Houston, TX 77024-1881

Mailing address

6555 Scarlet Pond LN
Fulshear, TX 77441-2524
Phone (313) 283-2118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200313000990 MI Practitioner - Nurse Practitioner 8628406220 Reassigns benefits to 1 organization
I20210623001942 TX Practitioner - Nurse Practitioner 8628406220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians

Practice addresses (Care Compare)

6850 Rufe Snow Dr
Fort Worth, TX 76148-2355
Phone (212) 734-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRNCNP1018576TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Consultants PLLC CurrentSince Jan 7, 2020 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Harmonious Living Home Current Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 1, 2021 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

21800 Haggerty Rd
Ste 113
Northville, MI 48167
Phone (734) 369-2100

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

8588 Katy Fwy
Ste 226A
Houston, TX 77024
Phone (713) 532-6884

Organizations & group practices 6

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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1154968279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 SCARLET POND LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774412524",
            "telephone_number": "313-283-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8588 KATY FWY STE 226A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241881",
            "telephone_number": "713-532-6884",
            "fax_number": "713-532-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "SHEREE",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "APRNCNP1018576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.