Individual provider Active NPI

Mattie Yulonda Sherard, NP-C

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1194919274
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000012272 Issued in TN
Practice address
6231 Perimeter Dr Ste 113
Chattanooga, TN 37421-3658
Phone
(423) 475-5088
NPI assigned
Aug 30, 2007
Last updated
Oct 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000012272 TN Primary

Addresses

Primary practice location

6231 Perimeter Dr Ste 113
Chattanooga, TN 37421-3658

Mailing address

3204 Millbrook Dr NW
Huntsville, AL 35810-3235
Phone (423) 400-3056

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12272TNMDPhysical Therapist
APN0000012272TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookside Medical Center PLLC Past Accepting new patients
HLR Healthcare Management Resources, LLC Family Past Accepting new patients
Healthforce Medical Group LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1194919274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 MILLBROOK DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358103235",
            "telephone_number": "423-400-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6231 PERIMETER DR STE 113",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213658",
            "telephone_number": "423-475-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERARD",
        "first_name": "MATTIE",
        "middle_name": "YULONDA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000012272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.