NPIMap

Organization Active NPI

Sheridan Community Hospital

Doing business as Sheridan Walk-in Clinic

  • Emergency Medicine Physician
  • Sheridan, MI
National Provider Identifier
1184289043
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SHERIDAN COMMUNITY HOSPITAL
Doing business as
Sheridan Walk-in Clinic
Practice address
301 N Main St
Sheridan, MI 48884-0279
Phone
(989) 291-3261
Fax
(989) 291-3062
NPI assigned
May 7, 2019
Reactivated
Jul 9, 2021
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SHERIDAN COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Mrs. Ljiljana Petricevic
Title
Ceo
Phone
(989) 291-6222

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

301 N Main St
Sheridan, MI 48884-0279

Mailing address

301 N Main St PO Box 279
Sheridan, MI 48884-0279
Phone (989) 291-3261

Other names 1

  • SHERIDAN WALK-IN CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sheridan Community Hosp5 organizations share this tax ID, including this one
Part of
Sheridan Community Hosp

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/84290569-a747-4440-964c-bf6fb9f7826f/
  • FHIR API: https://fhir-usa.unify.chbase.com/org/sherich-3b8c94f6

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1184289043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N MAIN ST PO BOX 279",
            "city": "SHERIDAN",
            "state": "MI",
            "postal_code": "488840279",
            "telephone_number": "989-291-3261",
            "fax_number": "989-291-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MAIN ST",
            "city": "SHERIDAN",
            "state": "MI",
            "postal_code": "488840279",
            "telephone_number": "989-291-3261",
            "fax_number": "989-291-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHERIDAN COMMUNITY HOSPITAL",
        "enumeration_date": "2019-05-07",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "deactivation_date": "2021-06-18",
        "reactivation_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "PETRICEVIC",
        "authorized_official_first_name": "LJILJANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-291-6222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHERIDAN WALK-IN CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHERIDAN WALK-IN CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheridan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.