Charlene A Sheridan, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

13198 Issued in CA

Practice address

1551 Bishop St Ste 310
San Luis Obispo, CA 93401-4637

Phone

(805) 242-4455

Fax

(805) 542-9589

NPI assigned

Dec 1, 2005

Last updated

Feb 27, 2017By the provider in NPPES

Sex

Female

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 1

Other names 1

• Charlene Ralston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Chris M Byrne DPM Inc

  dba San Luis Podiatry Group

  • Podiatrist
  • San Luis Obispo, CA
  • NPI 1649382052
  NPD (past)
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Morro Bay, CA
  • NPI 1841217882
  NPD (past)
• Community Health Centers of the Central Coast Inc

  dba Community Health Centers Cambria

  • Federally Qualified Health Center (FQHC)
  • Cambria, CA
  • NPI 1881611705
  NPD (past)
• Karen Ann Fong MD

  dba Asante Medical Group

  • Internal Medicine Physician
  • San Luis Obispo, CA
  • NPI 1629321849
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1245214469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST STE 310",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014637",
            "telephone_number": "805-242-4455",
            "fax_number": "805-542-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST STE 310",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014637",
            "telephone_number": "805-242-4455",
            "fax_number": "805-542-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "CHARLENE",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE #",
            "identifier": "13198",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "RALSTON",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Victoria Shepard-Moore
• Jennifer L. Shepard
• Kristin Shepard
• Jeri J Shepherd, D.D.S.
• Larry James Sherfield, LCSW
• Mark D Sherman, MD
• Cynthia Shibutani
• Madison Shields
• Shelley Lynn Shields
• Kara Anne Prinz Shipcott, MA

• Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.