Individual provider Active NPI

Michelle Renee Sherman, MSW

  • Social Worker
  • Madison, WI
National Provider Identifier
1255539052
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
615121 Issued in WI
Practice address
1210 Fourier Drive
Madison, WI 53717-1969
Phone
(608) 662-9327
Fax
(608) 662-9041
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 615121 WI Primary

Addresses

Primary practice location

1210 Fourier Drive
Madison, WI 53717-1969

Mailing address

1210 Fourier Drive
Madison, WI 53717-1969
Phone (608) 662-9327

Other identifiers 1

IdentifierTypeStateIssuer
40997600MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
615121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Spectrum Therapies of Delaware, LLC Past Accepting new patients
Autism Spectrum Therapies, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1255539052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 FOURIER DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171969",
            "telephone_number": "608-662-9327",
            "fax_number": "608-662-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 FOURIER DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171969",
            "telephone_number": "608-662-9327",
            "fax_number": "608-662-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "615121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40997600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.