Sheridan Medical LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHERIDAN MEDICAL LLC

Doing business as

Sheridan Medical Complex

Practice address

8400 Sheridan Rd
Kenosha, WI 53143-6327

Phone

(262) 658-4141

Fax

(262) 658-0618

NPI assigned

Mar 9, 2014

Last updated

Dec 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judah Bienstock

Title

Managing Member

Phone

(314) 631-3000

Specialties & licenses 1

Addresses

Other names 1

• Sheridan Medical Complex Doing business as

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

{
    "created_epoch": "1394323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1356767842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436327",
            "telephone_number": "262-658-4141",
            "fax_number": "262-658-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436327",
            "telephone_number": "262-658-4141",
            "fax_number": "262-658-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-09",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "BIENSTOCK",
        "authorized_official_first_name": "JUDAH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "314-631-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheridan Medical Complex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanne Sheen
• Shellie K Babcock, LCSW LLC
• Alison Amalia Shelton, FNP-BC
• Tori Shelton, LPC-IT
• Neil A Shepler, MD
• Jenna M Sherman, ATC
• Carol Shinske, BS
• Julie Ann Shinske, LPN
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• Shopko Stores Operating Co. LLC (ShopKo Optical 031)

• Skilled Nursing Facility in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.