Charles T Sherwood, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA432 Issued in ID

Practice address

777 N Raymond St
Boise, ID 83704-9251

Phone

(208) 367-6030

Fax

(208) 367-6123

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Directors of Idaho PLLCGroup PAC ID 1951628544, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medical Directors of Idaho PLLC

  • Internal Medicine Physician
  • Nampa, ID
  • NPI 1710392410
  Medicare reassignment Care Compare group
• Carepoint Health Emergency Medicine Idaho, PLLC

  • Emergency Medicine Physician
  • Caldwell, ID
  • NPI 1285275461
  Medicare reassignment
• Cep America, LLC

  • Emergency Medicine Physician
  • Boise, ID
  • NPI 1811357023
  Medicare reassignment
• Sound Physicians of Idaho

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461
  Medicare reassignment
• Cep America, LLC

  • Emergency Medicine Physician
  • Eagle, ID
  • NPI 1700246915
  NPD
• Full Circle Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1841490075
  NPD
• Healthy Habits Wellness Clinic Inc

  • Chiropractor
  • Meridian, ID
  • NPI 1336273267
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Idaho Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Meridian, ID
  • NPI 1730133208
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1215979000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-367-6030",
            "fax_number": "208-367-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-367-6030",
            "fax_number": "208-367-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "CHARLES",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806540800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807782300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth G. Sherman II, DDS
• Ian Donald Sherner, RN
• Tammie Louise Sherner, APRN-CNS
• Sherwood Chiropractic
• Barry G. Sherwood, D.C.
• Michael Joseph Shevlin, MD
• Sarah K Shewayish, MD
• Douglas J Shey, LPC
• SHH Medical Group Idaho, LLC
• Xiaoming Shi, MD

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.