NPIMap

Individual provider Active NPI

William Sherrod, M.D.

  • Emergency Medicine Physician
  • Bolivia, NC
National Provider Identifier
1275531006
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200101497 Issued in NC
Practice address
240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone
(843) 497-5929
NPI assigned
Jul 14, 2005
Last updated
Apr 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200101497 NC Primary

Addresses

Primary practice location

240 Hospital Dr NE
Bolivia, NC 28422-8346

Mailing address

PO Box 3439
North Myrtle Beach, SC 29582-0439
Phone (843) 839-4447

Other identifiers 1

IdentifierTypeStateIssuer
89133CKMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040928001114 NC Practitioner - Emergency Medicine 6507835360 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brunswick Community Hospital LLCGroup PAC ID 9335150895, 33 clinicians

Practice addresses (Care Compare)

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (336) 399-7678

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.86 of 100Reported as group
Quality
97.48
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200101497NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Jan 20, 2018 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Brunswick Community Hospital, LLC PastSince Oct 13, 2024 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

1 Medical Center Dr
Supply, NC 28462
Phone (910) 755-1286

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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 7

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1275531006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3439",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295820439",
            "telephone_number": "843-839-4447",
            "fax_number": "843-399-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "843-497-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERROD",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200101497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133CK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.