Active NPI
Sherwin Mark Stradling, OPTICIAN
- Optician
- Phoenix, AZ
National Provider Identifier
1164636858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 277
- Practice address
- 2040 W Bethany Home Rd
Suite 3
Phoenix, AZ 85015-2445 - Phone
- (602) 242-1950
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 277 | AZ | Primary |
Addresses
Primary practice location
2040 W Bethany Home Rd
Suite 3
Phoenix, AZ 85015-2445
Mailing address
2606 N 110TH Dr
Avondale, AZ 85323-5892
Phone (602) 242-3486
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 |
|---|---|---|---|
| 277 | AZ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164636858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2606 N 110TH DR",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853235892",
"telephone_number": "602-242-3486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 W BETHANY HOME RD",
"address_2": "SUITE 3",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850152445",
"telephone_number": "602-242-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRADLING",
"first_name": "SHERWIN",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.