NPIMap

Individual provider Active NPI

Sherry R. Hall, PA-C

  • Surgical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1245203397
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1786 Issued in NV
Practice address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 007274 GA
Surgical Physician Assistant 363AS0400X 0010-03118 NC
Surgical Physician Assistant 363AS0400X 50.001903 OH
Surgical Physician Assistant 363AS0400X PA1786 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609

Mailing address

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Other identifiers 4

IdentifierTypeStateIssuer
1245203397MedicaidNV
20297I6311OtherGAMEDICARE PTAN
164750MedicaidAL
003150687MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140927000437 GA Practitioner - Physician Assistant 9739130998 Reassigns benefits to 1 organization
I20161205000671 NV Practitioner - Physician Assistant 9739130998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

8402 Centennial Pkwy
Suite 240
Las Vegas, NV 89149-4793
Phone (702) 731-1616

Hospital & facility affiliations

  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007274GAMDSurgical Physician Assistant
0010-03118NCMDSurgical Physician Assistant
50.001903OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Orthopaedic Institute LLC CurrentSince Aug 7, 2014 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St Francis Health LLC Past Accepting new patients
Pinehurst Orthopedic Group, PA Orthopaedic Surgery Past Accepting new patients
St Francis Physician Practices LLC Past Accepting new patients
Mission Hospitals, Inc Past Accepting new patients
Desert Orthopaedic Billing LLC Orthopaedic Surgery Past Accepting new patients
Mission Hospital Inc Past Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste A101A
Columbus, GA 31904
Phone (706) 320-3128

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3787/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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 3

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1245203397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SHERRY",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "007274",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-03118",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.001903",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245203397",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20297I6311",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164750",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003150687",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.