Individual provider Active NPI

Sherbert V Canada-Mosby, M.S.W.

  • Social Worker
  • Smithville, MS
National Provider Identifier
1306026240
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
W6257 Issued in MS
Practice address
63420 Highway 25 N
Smithville, MS 38870-9700
Phone
(662) 651-4637
Fax
(662) 651-4636
NPI assigned
Nov 8, 2007
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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 W6257 MS Primary

Addresses

Primary practice location

63420 Highway 25 N
Smithville, MS 38870-9700

Mailing address

1030 Jefferson Ave
Memphis, TN 38104-2127
Phone (901) 523-8990

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
W6257MSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Access Family Health Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1306026240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990",
            "fax_number": "901-577-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63420 HIGHWAY 25 N",
            "city": "SMITHVILLE",
            "state": "MS",
            "postal_code": "388709700",
            "telephone_number": "662-651-4637",
            "fax_number": "662-651-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA-MOSBY",
        "first_name": "SHERBERT",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "W6257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.