Active NPI
Sandra Kay Sheridan, RPA-C
- Physician Assistant
- Binghamton, NY
National Provider Identifier
1316107071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 006396
- Practice address
- 249 Glenwood Rd
Binghamton, NY 13905-1603 - Phone
- (607) 770-0348
- Fax
- (607) 770-0354
- NPI assigned
- Jun 16, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 006396 | NY | Primary |
Addresses
Primary practice location
249 Glenwood Rd
Binghamton, NY 13905-1603
Mailing address
249 Glenwood Rd
Binghamton, NY 13905-1603
Phone (607) 770-0348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140402001490 | NY | Order and Referring Only - Physician Assistant | 2365673498 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006396-1 | NY | MD | Mental Health Counselor |
| 006396 | NY | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1316107071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 GLENWOOD RD",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051603",
"telephone_number": "607-770-0348",
"fax_number": "607-770-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 GLENWOOD RD",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051603",
"telephone_number": "607-770-0348",
"fax_number": "607-770-0354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "SANDRA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "RPA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-16",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "006396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.