Active NPI
Charles Alan Sherrill, DMD
- General Practice Dentistry
- Russellville, AL
National Provider Identifier
1306953658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3897
- Practice address
- 15591 Hwy 43
Russellville, AL 35653 - Phone
- (256) 332-9733
- Fax
- (256) 331-0780
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3897 | AL | Primary |
Addresses
Primary practice location
15591 Hwy 43
Russellville, AL 35653
Mailing address
PO Box 336
15991 Hwy 43
Russellville, AL 35653
Phone (256) 332-9733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51076493 | Other | AL | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3897 | AL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306953658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 336",
"address_2": "15991 HWY 43",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "35653",
"telephone_number": "256-332-9733",
"fax_number": "256-331-0780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15591 HWY 43",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "35653",
"telephone_number": "256-332-9733",
"fax_number": "256-331-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRILL",
"first_name": "CHARLES",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "3897",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51076493",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.