Individual provider Active NPI

Sherisse Thompson

  • Social Worker
  • Bronx, NY
National Provider Identifier
1316525934
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
110261 Issued in NY
Practice address
773 Concourse VLG E Apt 1a
Bronx, NY 10451-3905
Phone
(347) 417-6165
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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 110261 NY Primary

Addresses

Primary practice location

773 Concourse VLG E Apt 1a
Bronx, NY 10451-3905

Mailing address

773 Concourse VLG E Apt 1a
Bronx, NY 10451-3905
Phone (347) 417-6165

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
110261NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1316525934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 CONCOURSE VLG E APT 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513905",
            "telephone_number": "347-417-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 CONCOURSE VLG E APT 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513905",
            "telephone_number": "347-417-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHERISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "110261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.