Individual provider Active NPI

Sharon Smotherman, PAC

  • Physician Assistant
  • Sitka, AK
National Provider Identifier
1356471528
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
369 Issued in AK
Practice address
700 Katlian St Ste E
Sitka, AK 99835-7359
Phone
(907) 747-5861
Fax
(907) 747-5415
NPI assigned
Mar 6, 2007
Last updated
Jun 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 369 AK Primary

Addresses

Primary practice location

700 Katlian St Ste E
Sitka, AK 99835-7359

Mailing address

700 Katlian St Ste E
Sitka, AK 99835-7359
Phone (907) 747-5861

Other identifiers 1

IdentifierTypeStateIssuer
MD0079MedicaidAK

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
369AKMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1356471528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 KATLIAN ST STE E",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357359",
            "telephone_number": "907-747-5861",
            "fax_number": "907-747-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 KATLIAN ST STE E",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357359",
            "telephone_number": "907-747-5861",
            "fax_number": "907-747-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMAN",
        "first_name": "SHARON",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0079",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sitka, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.