NPIMap

Organization Active NPI

Full Life Primary Care PLLC

Doing business as Full Life Primary Care

  • Adult Medicine Physician
  • Sherman, TX
National Provider Identifier
1427775451
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
FULL LIFE PRIMARY CARE PLLC
Doing business as
Full Life Primary Care
Practice address
600 E Taylor St Ste 201
Sherman, TX 75090-2832
Phone
(903) 257-3929
Fax
(903) 827-4015
NPI assigned
Oct 20, 2022
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Sheelu Mathews, MDNPI 1750578258
Title
Manager
Phone
(973) 207-4589

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

600 E Taylor St Ste 201
Sherman, TX 75090-2832

Mailing address

600 E Taylor St Ste 201
Sherman, TX 75090-2832
Phone (903) 257-3929

Other names 1

  • Full Life Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221128000639 TX Part B Supplier - Clinic/Group Practice 8224406103 Receives reassigned benefits from 7 practitioners
Practice locations: Denison, TX; Sherman, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2277489Full Life Primary Care600 E Taylor St Suite 201, Sherman, TX 75090Certificate of waiverFeb 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1427775451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E TAYLOR ST STE 201",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750902832",
            "telephone_number": "903-257-3929",
            "fax_number": "903-827-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E TAYLOR ST STE 201",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750902832",
            "telephone_number": "903-257-3929",
            "fax_number": "903-827-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL LIFE PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "SHEELU",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-207-4589",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Full Life Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Full Life Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.