Individual provider Active NPI

Nicole Sheldon

  • Pediatrics Physician
  • Metairie, LA
National Provider Identifier
1164819686
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
320331 Issued in LA
Practice address
4740 S I 10 Service Rd W Ste 200
Metairie, LA 70001-1244
Phone
(504) 908-6253
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 320331 LA Primary

Addresses

Primary practice location

4740 S I 10 Service Rd W Ste 200
Metairie, LA 70001-1244

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 894-6783

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 894-6783

Other identifiers 1

IdentifierTypeStateIssuer
2391046MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20190916000582 LA Practitioner - Pediatric Medicine 7416213954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Medical Practice CorporationGroup PAC ID 5597944579, 48 clinicians

Practice addresses (Care Compare)

3040 33Rd St
Metairie, LA 70001-2036
Phone (504) 219-0880

4224 Houma Blvd
Suite 240
Metairie, LA 70006-2935
Phone (504) 885-4141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320331LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Children'S Hospital Pediatrics Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

4740 S I 10 Service Rd W
Ste 200
Metairie, LA 70001
Phone (504) 988-5458

4720 S I 10 Service Rd W
Ste 200
Metairie, LA 70001
Phone (504) 988-7542

4845 Veterans Memorial Blvd
Metairie, LA 70006

4224 Houma Blvd
Ste 240
Metairie, LA 70006
Phone (504) 885-4141

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 3

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1164819686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-894-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 S I 10 SERVICE RD W STE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011244",
            "telephone_number": "504-908-6253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185720",
            "country_code": "US",
            "telephone_number": "504-894-6783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "320331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2391046",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.