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Organization Active NPI

Jeffrey Sheedy DO LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Plymouth, IN
National Provider Identifier
1437356243
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
JEFFREY SHEEDY DO LLC
Practice address
2855 Miller Dr
Suite 109
Plymouth, IN 46563
Phone
(574) 941-1040
Fax
(574) 935-0080
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Dr. Jeffrey M Sheedy, D.O.
Title
Owner Physcian
Phone
(574) 935-9395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

2855 Miller Dr
Suite 109
Plymouth, IN 46563

Mailing address

P O Box 437
Plymouth, IN 46563
Phone (574) 941-1040

Other identifiers 1

IdentifierTypeStateIssuer
200384260MedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1437356243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 437",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "46563",
            "telephone_number": "574-941-1040",
            "fax_number": "574-935-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 MILLER DR",
            "address_2": "SUITE 109",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "46563",
            "telephone_number": "574-941-1040",
            "fax_number": "574-935-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SHEEDY DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "SHEEDY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PHYSCIAN",
        "authorized_official_telephone_number": "574-935-9395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200384260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.