Shari Jean Hiatt, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2022-0103 Issued in NM

Practice address

110 Sheep Springs Rd
Jemez Pueblo, NM 87024-0731

Phone

(575) 834-7413

Fax

(575) 834-3081

NPI assigned

Feb 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Shari Jean White Former name

Medicare fee-for-service enrollment

Enrolled in AZ, TX, NM3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Winslow Indian Health Care Center IncGroup PAC ID 4284548991, 99 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment Care Compare group
• Pueblo of Jemez

  • Clinic/Center
  • Jemez Pueblo, NM
  • NPI 1417082215

  TX

  Medicare reassignment NPD
• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Medicare reassignment
• Nextcare Arizona LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment
• Pueblo of Jemez

  • Clinic/Center
  • Jemez Pueblo, NM
  • NPI 1225346547
  NPD
• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684
  NPD
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD
• Winslow Indian Health Care Center, Inc

  • Land Ambulance
  • Winslow, AZ
  • NPI 1477827368
  NPD
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Leupp, AZ
  • NPI 1760652580
  NPD
• After Hours Pediatrics PC

  • Pediatrics Physician
  • Albuquerque, NM
  • NPI 1588730360
  NPD (past)
• Unm Medical Group Inc

  • Developmental Disabilities Clinic/Center
  • Albuquerque, NM
  • NPI 1851614432
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1447222930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNMH FAMILY PRACTICE 24",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871313630",
            "telephone_number": "505-272-1734",
            "fax_number": "928-774-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SHEEP SPRINGS RD",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "870240731",
            "telephone_number": "575-834-7413",
            "fax_number": "575-834-3081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Tucker Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871311816",
            "country_code": "US",
            "telephone_number": "505-272-1734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2920 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860041816",
            "country_code": "US",
            "telephone_number": "928-213-6100",
            "fax_number": "928-774-4808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIATT",
        "first_name": "SHARI",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0103",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3535",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0303P",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2022-0103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324670",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30331845",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARI",
            "last_name": "WHITE",
            "middle_name": "JEAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Raymond Gooris, PA-C
• Robert A Gracey, OD
• Megan Patricia Greteman, PA-C
• Nancy Maybeth Harvey, RN, BSN, MPH
• Michael Hennelly, MD
• Rachel Houseman, LPAT ATRBC LPCC
• Jemez Valley Community Wellness
• Jemez Valley Public Schools
• Roylynda Johnson, RDH
• Felipita Loretto, CCHW

• Medical Physician Assistant in Jemez Pueblo, NM
• Providers in Jemez Pueblo, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.