Active NPI
Randy Lynn Sherbon Sr.
- Prosthetics Case Management
- Denver, CO
National Provider Identifier
1457506669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- Practice address
- 1055 Clermont St
Denver, CO 80220-3808 - Phone
- (303) 393-4633
- Fax
- (303) 393-4685
- NPI assigned
- Dec 2, 2008
- 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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | Primary |
Addresses
Primary practice location
1055 Clermont St
Denver, CO 80220-3808
Mailing address
1055 Clermont St
Denver, CO 80220
Phone (303) 393-4633
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225000000X | Other | CO | ORTHO PROSTH FITTER |
| 222Z00000X | Other | CO | ORTHOTIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228176000000",
"number": "1457506669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 CLERMONT ST",
"city": "DENVER",
"state": "CO",
"postal_code": "80220",
"telephone_number": "303-393-4633",
"fax_number": "303-393-4685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 CLERMONT ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802203808",
"telephone_number": "303-393-4633",
"fax_number": "303-393-4685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERBON",
"first_name": "RANDY",
"middle_name": "LYNN",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-02",
"last_updated": "2008-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORTHO PROSTH FITTER",
"identifier": "225000000X",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORTHOTIST",
"identifier": "222Z00000X",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.