Individual provider Active NPI

Sharon Priesand, PA-C

  • Physician Assistant
  • Lyndhurst, OH
National Provider Identifier
1194121608
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.001239 Issued in OH
Practice address
29017 Cedar Rd
Lyndhurst, OH 44124-4073
Phone
(440) 460-8000
NPI assigned
Nov 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.001239 OH Primary

Addresses

Primary practice location

29017 Cedar Rd
Lyndhurst, OH 44124-4073

Mailing address

29017 Cedar Rd
Lyndhurst, OH 44124-4073
Phone (440) 460-8000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50.001239OHMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1194121608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29017 CEDAR RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244073",
            "telephone_number": "440-460-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29017 CEDAR RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244073",
            "telephone_number": "440-460-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIESAND",
        "first_name": "SHARON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.001239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.