Active NPI
Jesse A Sherrod III, M.D.
- Obstetrics & Gynecology Physician
- Las Vegas, NV
National Provider Identifier
1457339103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 6325
- Practice address
- 8906 Spanish Ridge Ave Ste 202
Las Vegas, NV 89148-1319 - Phone
- (702) 330-3102
- Fax
- (702) 912-4994
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 6325 | NV | Primary |
Addresses
Primary practice location
8906 Spanish Ridge Ave Ste 202
Las Vegas, NV 89148-1319
Mailing address
8906 Spanish Ridge Ave Ste 202
Las Vegas, NV 89148-1319
Phone (702) 330-3102
Other practice location 1
1707 W Charleston Blvd
#120, Patient Care Center
Las Vegas, NV 89102-2351
Phone (702) 671-5140
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CS06312 | Other | NV | PHARMACY/CDS |
| 002018337 | Medicaid | NV |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6325 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1457339103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8906 SPANISH RIDGE AVE STE 202",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891481319",
"telephone_number": "702-330-3102",
"fax_number": "702-912-4994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8906 SPANISH RIDGE AVE STE 202",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891481319",
"telephone_number": "702-330-3102",
"fax_number": "702-912-4994"
}
],
"practiceLocations": [
{
"address_1": "1707 W Charleston Blvd",
"address_2": "#120, Patient Care Center",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891022351",
"country_code": "US",
"telephone_number": "702-671-5140",
"fax_number": "702-385-2745",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHERROD",
"first_name": "JESSE",
"middle_name": "A",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NV",
"license": "6325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY/CDS",
"identifier": "CS06312",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002018337",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.