Active NPI
Momodu Sheriff, M.D.
- Family Medicine Physician
- Highland, IN
National Provider Identifier
1437554144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11009906A
- Practice address
- 2646 Highway Ave
Suite 102
Highland, IN 46322-1661 - Phone
- (219) 595-0604
- Fax
- (219) 513-8678
- NPI assigned
- Oct 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11009906A | IN | Primary |
Addresses
Primary practice location
2646 Highway Ave
Suite 102
Highland, IN 46322-1661
Mailing address
42633 Garfield Rd
Suite 315
Clinton TWP, MI 48038-5033
Phone (888) 819-4677
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11009906A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1437554144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42633 GARFIELD RD",
"address_2": "SUITE 315",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480385033",
"telephone_number": "888-819-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2646 HIGHWAY AVE",
"address_2": "SUITE 102",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463221661",
"telephone_number": "219-595-0604",
"fax_number": "219-513-8678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIFF",
"first_name": "MOMODU",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-24",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11009906A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.