Scott Sheridan, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0013026 Issued in CO

Practice address

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610

Phone

(313) 640-2300

NPI assigned

Jan 9, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1487190898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ROTH BLVD",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 KERCHEVAL AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363610",
            "telephone_number": "313-640-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0013026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssheridan993398@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "159 Kercheval Ave",
            "city": "Grosse Pointe Farms",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482363610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daryn Lynn Schwartz, DPT
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• Gary A Shoemaker, D.C.
• Shorepointe Emergency Care Physicians PC
• Diane Sharon Smith, PHD MSW APRN BC CNS
• Michelle Smith, LPN
• Ty'Esha Dezalynn la'Nae Smith

• Physical Therapy Assistant in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.