Sharon Ellen Omalley, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3407 Issued in AZ

Practice address

3505 Western Ave
Mohave Mental Health Clinic Inc
Kingman, AZ 86409

Phone

(928) 757-8111

Fax

(928) 757-3256

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Sharon Ellen Omalley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mohave Primary Care

  • Specialist
  • Kingman, AZ
  • NPI 1700909330
  NPD (past)
• Sycamore Avenue Medical Center, PLLC

  • Family Nurse Practitioner
  • Kingman, AZ
  • NPI 1245762491
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174546360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 SYCAMORE AVE",
            "address_2": "MOHAVE MENTAL HEALTH CLINIC INC",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 WESTERN AVE",
            "address_2": "MOHAVE MENTAL HEALTH CLINIC INC",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMALLEY",
        "first_name": "SHARON",
        "middle_name": "ELLEN",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "OMALLEY",
            "middle_name": "ELLEN",
            "prefix": "MRS.",
            "credential": "PA C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Oberg, PHD
• Ryan Obregon, RPH
• Melissa Ogden, FNP
• Abhinav Ohri
• Brad David Oliverson, D.O.
• Craig Masao Ono, MD
• Piankhi Othelot, M.D
• Joan A. Oursler, OTR/L
• Overcome Counseling PLLC
• Danni Denise Owens, FNP

• Physician Assistant in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Physician Assistant in Arizona

• 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.