Sheryl Kimberly Gore, F.N.P.
Individual provider Active NPI Family Nurse Practitioner · Hereford, AZ
NPI 1457538431 · NPPES record last updated Apr 8, 2024
Key facts
- NPI
- 1457538431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 305422 (AZ)
- Practice address
- 10524 E Highway 92
Hereford, AZ 85615-8371 - Phone
- (520) 366-0300
- Fax
- (520) 366-0400
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bisbee Hospital Association
Tri-State Medical Specialists LLC
Practice addresses (Care Compare)
101 Cole Ave
Bisbee, AZ 85603-1327
Phone (520) 432-5383
1510 E Wagon Wheel LN
Suite 110
Fort Mohave, AZ 86426-6698
Phone (928) 788-3333
Hospital & facility affiliations
- Copper Queen Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA, AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080507000102 | LA | Practitioner - Nurse Practitioner | 1557440260 | Reassigns benefits to 1 organization |
| I20240523002595 | AZ | Practitioner - Nurse Practitioner | 1557440260 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081278-05327 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hulin Urgent Care Services LLC | Current |
Accepting new patients | |
| Tri-State Medical Specialists LLC | Family | Current |
Accepting new patients |
| Bisbee Hospital Association | Current |
Accepting new patients | |
| Tri-State Medical Specialists LLC | Current |
Accepting new patients | |
| Bisbee Hospital Association | Current |
Accepting new patients | |
| Bisbee Hospital Association | Current | Accepting new patients | |
| Hulin Urgent Care Services LLC | Current |
Accepting new patients | |
| Ahs Walk in Clinic Inc | Past | Accepting new patients | |
| Bisbee Hospital Association | Past | Accepting new patients |
Locations
7 Bisbee Rd
Bisbee, AZ 85603
Phone (520) 432-2042
101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383
100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659
1510 E Wagon Wheel Ln
Ste 110
Fort Mohave, AZ 86426
Phone (904) 994-5560
10524 E Highway 92
Hereford, AZ 85615
Phone (520) 366-0300
4524 E Hereford Rd
Ste 1
Hereford, AZ 85615
600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720
1110 E Saint Peter St
New Iberia, LA 70560
Phone (337) 364-1166
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 081278-05327 | LA | |
| Family Nurse Practitioner | 363LF0000X | 305422 | AZ | Yes |
Addresses
Primary practice location
10524 E Highway 92
Hereford, AZ 85615-8371
Mailing address
648 Suffolk Dr
Sierra Vista, AZ 85635-4766
Phone (318) 738-6101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1035009 | Medicaid | LA |
Other names
- Ms. Sheryl Ransom Kindrick
Other providers in Hereford, AZ
- Justin Gause
- Steven Richard Germann
- Goldenoaks
- Danitza Areli Gonzalez
- Kara L Gordon
- Thomas Alcott Harris
- Yolanda J Harvey
- Diana Deray Jones
- Jessica Lea Joyce
- Kara L. Montes, D.P.M., PC
All providers in Hereford, AZ · Family Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.