Sheryl Niccum, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP2438 Issued in AZ

Practice address

18275 N 59TH Avenue
BLDG K, Suite 162
Glendale, AZ 85308

Phone

(602) 547-8184

Fax

(602) 547-8339

NPI assigned

Nov 9, 2005

Last updated

Nov 6, 2014By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment NPD
• McDowell West Internal Medicine PC

  • Internal Medicine Physician
  • Goodyear, AZ
  • NPI 1689811630
  NPD (past)
• Cardiovascular Associates PC

  • Cardiovascular Disease Physician
  • Marion, IN
  • NPI 1447430863
  NPD (past)
• Indiana Medical Associates, LLC

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1780628545
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1457332199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVENUE",
            "address_2": "BLDG K, SUITE 162",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-547-8184",
            "fax_number": "602-547-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18275 N 59TH AVENUE",
            "address_2": "BLDG K, SUITE 162",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-547-8184",
            "fax_number": "602-547-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICCUM",
        "first_name": "SHERYL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488740",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tania Duc Nguyen, DDS
• Thanh Vu Nguyen, L.AC
• Theo Nguyen
• Trung Nguyen
• Ni'Lee Treatment Center LLC
• Andrea Nicholls, MOT
• Raymee Nichols
• James Lee Nicholson Jr.
• Susanna Emilia Nickel, PA
• Corri Sueko Nickele, O.T.R. L

• Family Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.