Juan Jose Sherwood, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

032470 Issued in GA

Practice address

150 Medical Blvd
Suite B
Stockbridge, GA 30281-5053

Phone

(770) 389-9944

Fax

(770) 389-1973

NPI assigned

Aug 3, 2005

Last updated

Sep 30, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 16

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Southern Crescent Pediatrics PC

  • Pediatrics Physician
  • Ellenwood, GA
  • NPI 1437145950
  NPD (past) Authorized official
• Southern Crescent Pediatrics PC

  • Pediatrics Physician
  • Riverdale, GA
  • NPI 1548252562
  NPD (past) Authorized official
• Southern Crescent Pediatrics PC

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1972595999
  NPD (past) Authorized official

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1417958281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MEDICAL BLVD",
            "address_2": "SUITE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815053",
            "telephone_number": "770-389-9944",
            "fax_number": "770-389-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEDICAL BLVD",
            "address_2": "SUITE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815053",
            "telephone_number": "770-389-9944",
            "fax_number": "770-389-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "032470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SOURCE",
            "identifier": "0110001605",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "581487734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER POS",
            "identifier": "7802",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO / CIGNA",
            "identifier": "581487734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "581487734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUCARE",
            "identifier": "581487734002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000413993A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL",
            "identifier": "581487734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC HEALTHSOURCE",
            "identifier": "S06119",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SELECT / US HEALTHC",
            "identifier": "0526682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "276714",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMINA CLAIMS",
            "identifier": "581487734",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000413993B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000413993D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1202577",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEP / BCBS",
            "identifier": "276714",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Ann Shepherd
• Paul Andrew Shepherd, D.M.D.,M.S.
• Shepherdcare Hospice,LLC (Aveanna Hospice)
• Kendra Sherard-Solomon
• Cynthia A Sherrod
• Sachin Sheth, MD
• Deandra Marie Shields, DPT
• Ashley Shim
• Keesha Simone Shine
• Gina Shipman, PA-C

• Pediatrics Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatrics Physician in Georgia

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