Individual provider Active NPI

Sherine B Parker, M.D.

  • Pediatrics Physician
  • Vista, CA
National Provider Identifier
1477626513
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G81658 Issued in CA
Practice address
2067 W Vista Way
Suite 280
Vista, CA 92083-6031
Phone
(760) 941-3630
Fax
(760) 941-1214
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G81658 CA Primary

Addresses

Primary practice location

2067 W Vista Way
Suite 280
Vista, CA 92083-6031

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other identifiers 1

IdentifierTypeStateIssuer
00G816580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025001062 CA Practitioner - Pediatric Medicine 2365403086 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G81658CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Rady Children'S Hospital San Diego Pediatrics Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1477626513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 280",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-941-3630",
            "fax_number": "760-941-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SHERINE",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G81658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G816580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.