NPIMap

Individual provider Active NPI

Carmen Michelle Sherry, CRNP

  • Nurse Practitioner
  • Altoona, PA
National Provider Identifier
1215623327
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027619 Issued in PA
Practice address
501 Howard Ave
Altoona, PA 16601-4810
Phone
(814) 944-2107
NPI assigned
Apr 12, 2023
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN577159 PA
Nurse Practitioner 363L00000X SP027619 PA Primary

Addresses

Primary practice location

501 Howard Ave
Altoona, PA 16601-4810

Mailing address

2382 Bald Eagle Pike
Tyrone, PA 16686-7718
Phone (814) 931-9504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230817000253 PA Practitioner - Nurse Practitioner 8628317898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blair Renal Associates IncGroup PAC ID 3072405489, 3 clinicians

Practice addresses (Care Compare)

501 Howard Ave
Suite D204
Altoona, PA 16601-4814
Phone (814) 944-2107

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN577159PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blair Renal Associates Inc CurrentSince Jul 13, 2023 Accepting new patients

Locations

501 Howard Ave
Ste D204
Altoona, PA 16601
Phone (814) 944-2107

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDACBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IDACBA/Endpoint/IDACBA

Organizations & group practices 1

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1215623327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 BALD EAGLE PIKE",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166867718",
            "telephone_number": "814-931-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HOWARD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014810",
            "telephone_number": "814-944-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRY",
        "first_name": "CARMEN",
        "middle_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "RN577159",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.