Active NPI
Sharon A. McKenna, D.O.
- Family Medicine Physician
- Henderson, NV
National Provider Identifier
1497705222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2418
- Practice address
- 874 American Pacific Dr
Henderson, NV 89014-8800 - Phone
- (702) 777-4809
- Fax
- (702) 777-4822
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2418 | NV | Primary |
| Family Medicine Physician | 207Q00000X | OS12638 | FL |
Addresses
Primary practice location
874 American Pacific Dr
Henderson, NV 89014-8800
Mailing address
1801 W Olympic Blvd # 2265
Pasadena, CA 91199-0001
Other practice location 1
12780 Race Track Rd
Suite 300
Tampa, FL 33626-1395
Phone (813) 792-9541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2418 | NV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Touro University | Family Medicine | Current | Accepting new patients |
Locations
1801 W Olympic Blvd
#2265
Pasadena, CA 91199
874 American Pacific Dr
Henderson, NV 89014
Phone (702) 777-4808
Interoperability endpoints
- sharonmckenna@tu.allscriptsdirect.net
Organizations & group practices 1
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": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1497705222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 W OLYMPIC BLVD # 2265",
"city": "PASADENA",
"state": "CA",
"postal_code": "911990001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "874 AMERICAN PACIFIC DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890148800",
"telephone_number": "702-777-4809",
"fax_number": "702-777-4822"
}
],
"practiceLocations": [
{
"address_1": "12780 Race Track Rd",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336261395",
"country_code": "US",
"telephone_number": "813-792-9541",
"fax_number": "813-443-8170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENNA",
"first_name": "SHARON",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "2418",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS12638",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.