NPIMap

Individual provider Active NPI

Sherif M. Shoukry, M.D.

  • Emergency Medicine Physician
  • Richlands, VA
National Provider Identifier
1184664872
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
101045469 Issued in VA
Practice address
2949 West Front Street
Richlands, VA 24641-2099
Phone
(276) 596-6000
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 101045469 VA Primary
Emergency Medicine Physician 207P00000X 45866 TN

Addresses

Primary practice location

2949 West Front Street
Richlands, VA 24641-2099

Mailing address

PO Box 634706
Cincinnati, OH 45263-0001
Phone (865) 292-3000

Other identifiers 6

IdentifierTypeStateIssuer
0075556000MedicaidWV
1184664872MedicaidVA
P00233625OtherVARAILROAD MEDICARE
010257107MedicaidVA
7100109980MedicaidKY
1518477MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000319 TN Practitioner - Emergency Medicine 9133155708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 559-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45866TNMDEmergency Medicine Physician
101045469VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Putnam Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Medical Observation Services LLC Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients

Locations

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1184664872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634706",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "865-292-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 WEST FRONT STREET",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412099",
            "telephone_number": "276-596-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUKRY",
        "first_name": "SHERIF",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "101045469",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "45866",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075556000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184664872",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00233625",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010257107",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100109980",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518477",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richlands, VA

Sources for this page

Verify at the official NPI Registry.