Individual provider Active NPI

Heather M Sheridan Revel

  • Pharmacist
  • Rehoboth Beach, DE
National Provider Identifier
1356805204
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A1-0004557 Issued in DE
Practice address
19869 Sea Blossom Blvd
Rehoboth Beach, DE 19971-7142
Phone
(302) 226-7791
Fax
(302) 226-7796
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X A1-0004557 DE Primary

Addresses

Primary practice location

19869 Sea Blossom Blvd
Rehoboth Beach, DE 19971-7142

Mailing address

19869 Sea Blossom Blvd
Rehoboth Beach, DE 19971-7142
Phone (302) 226-7791

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
A1-0004557DEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware CVS Pharmacy LLC Past Accepting new patients
Delaware CVS Pharmacy, L.L.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1356805204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19869 SEA BLOSSOM BLVD",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199717142",
            "telephone_number": "302-226-7791",
            "fax_number": "302-226-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19869 SEA BLOSSOM BLVD",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199717142",
            "telephone_number": "302-226-7791",
            "fax_number": "302-226-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN REVEL",
        "first_name": "HEATHER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.