Individual provider Active NPI

Sherry K. Schillo, PAC

  • Physician Assistant
  • Miles City, MT
National Provider Identifier
1285641324
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
203 Issued in MT
Practice address
620 S Haynes Ave
Miles City, MT 59301-4769
Phone
(406) 233-7000
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20131001000523 ND Practitioner - Physician Assistant 6406850866 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Sep 6, 2013 Accepting new patients
Sanford Bismarck CurrentSince Sep 6, 2013 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222

1531 W Villard St
Dickinson, ND 58601
Phone (701) 225-7575

801 21st Ave SE
Minot, ND 58701
Phone (701) 838-3033

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 203 MT Primary

Addresses

NPPES NPI Registry

Primary practice location

620 S Haynes Ave
Miles City, MT 59301-4769

Mailing address

PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0439875OtherMTMDCD PIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 27, 2008.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1285641324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100",
            "telephone_number": "406-238-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S HAYNES AVE",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593014769",
            "telephone_number": "406-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLO",
        "first_name": "SHERRY",
        "middle_name": "K.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCD PIN",
            "identifier": "0439875",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

Verify at the official NPI Registry.