Michele Miller Sharp, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15-01083 Issued in KS

Practice address

200 East Pack
Moundridge, KS 67107

Phone

(620) 345-6322

Fax

(620) 345-3038

NPI assigned

Jan 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346229465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAST PACK",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "67107",
            "telephone_number": "620-345-6322",
            "fax_number": "620-345-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAST PACK",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "67107",
            "telephone_number": "620-345-6322",
            "fax_number": "620-345-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "MICHELE",
        "middle_name": "MILLER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-01083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "426960",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460684",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH SYSTEMS",
            "identifier": "15419",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James D Ratzlaff, M.D.
• Revive Therapy and Performance, LLC (Revive Therapy and Performance)
• Ashley Dyan Roberts, PT, DPT
• Nichole Marie Schroeder, OTR
• Gaven Schumann
• Cindy Lee Stucky, PTA
• Karen L Stucky, CPTA
• Marla R Ullom-Minnich, M.D.
• Paul D Ullom-Minnich, M.D.
• Sarah Elizabeth Unruh

• Medical Physician Assistant in Moundridge, KS
• Providers in Moundridge, KS by specialty
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.