Individual provider Active NPI

Jason E. Sharp, MD

  • Family Medicine Physician
  • Quincy, IL
National Provider Identifier
1366470510
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-114538 Issued in IL
Practice address
927 Broadway St
Quincy, IL 62301-2719
Phone
(217) 223-8400
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-114538 IL
Family Medicine Physician 207Q00000X 036-114538 IL Primary

Addresses

Primary practice location

927 Broadway St
Quincy, IL 62301-2719

Mailing address

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 223-8400

Other identifiers 1

IdentifierTypeStateIssuer
036-114538OtherILSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181213001448 WY Practitioner - Family PracticePractitioner - Sports Medicine 7012920440 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-114538ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Lincoln County Hospital District Family Medicine CurrentSince Oct 8, 2018 Accepting new patients
North Lincoln County Hospital District CurrentSince Oct 8, 2018 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

122 Petersen Pkwy
Thayne, WY 83127
Phone (307) 883-4437

Interoperability endpoints

  • Direct secure messaging: jsharp624959@direct.ochin.org

Organizations & group practices 3

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1366470510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012719",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012719",
            "telephone_number": "217-223-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JASON",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-114538",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-114538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "036-114538",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.