Active NPI
Charles Donald Sherrard Jr., MD
- Emergency Medicine Physician
- Louisville, KY
National Provider Identifier
1184602294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 24279
- Practice address
- 200 Abraham Flexnor Way
Louisville, KY 40202-1821 - Phone
- (502) 587-4421
- Fax
- (502) 361-9947
- NPI assigned
- Jan 9, 2006
- Last updated
- Jun 14, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 24279 | KY | Primary |
Addresses
Primary practice location
200 Abraham Flexnor Way
Louisville, KY 40202-1821
Mailing address
5454 New Cut Rd
Ste 5
Louisville, KY 40214-4271
Phone (502) 361-9900
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930059277 | Other | RAILROAD MEDICARE | |
| 029882600 | Other | FEDERAL BLACK LUNG GROUP | |
| 1063865 | Other | KY | PASSPORT |
| 64242795 | Medicaid | KY | |
| 000000057678 | Other | KY | ANTHEM GROUP NUMBER |
| 200206770A | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1184602294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5454 NEW CUT RD",
"address_2": "STE 5",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402144271",
"telephone_number": "502-361-9900",
"fax_number": "502-361-9947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ABRAHAM FLEXNOR WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021821",
"telephone_number": "502-587-4421",
"fax_number": "502-361-9947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRARD",
"first_name": "CHARLES",
"middle_name": "DONALD",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "24279",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "930059277",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLACK LUNG GROUP",
"identifier": "029882600",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "1063865",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64242795",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM GROUP NUMBER",
"identifier": "000000057678",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200206770A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.