Active NPI
Mark Charles Schermerhorn, MS, CCC-SLP
- Speech-Language Pathologist
- Ganado, AZ
National Provider Identifier
1346574399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4162
- Practice address
- Sage Memorial Hospital
Hwy 264
Ganado, AZ 86505 - Phone
- (928) 755-4566
- Fax
- (928) 755-4567
- NPI assigned
- Sep 23, 2009
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4162 | AZ | Primary |
Addresses
Primary practice location
Sage Memorial Hospital
Hwy 264
Ganado, AZ 86505
Mailing address
PO Box 457
Sage Memorial Hospital
Ganado, AZ 86505
Phone (928) 755-4566
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4162 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253664000000",
"number": "1346574399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 457",
"address_2": "SAGE MEMORIAL HOSPITAL",
"city": "GANADO",
"state": "AZ",
"postal_code": "86505",
"telephone_number": "928-755-4566",
"fax_number": "928-755-4567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SAGE MEMORIAL HOSPITAL",
"address_2": "HWY 264",
"city": "GANADO",
"state": "AZ",
"postal_code": "86505",
"telephone_number": "928-755-4566",
"fax_number": "928-755-4567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHERMERHORN",
"first_name": "MARK",
"middle_name": "CHARLES",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-23",
"last_updated": "2009-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "4162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ganado, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.