Active NPI
Reginald Robert Sherrill, M.D.
- Plastic Surgery Physician
- Dalton, GA
National Provider Identifier
1528007663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 023677
- Practice address
- 1501 Broadrick Dr
Suite 1
Dalton, GA 30720-3014 - Phone
- (706) 226-3311
- Fax
- (706) 275-8723
- NPI assigned
- Jun 5, 2006
- Last updated
- Mar 19, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 023677 | GA | Primary |
Addresses
Primary practice location
1501 Broadrick Dr
Suite 1
Dalton, GA 30720-3014
Mailing address
1501 Broadrick Dr
Suite 1
Dalton, GA 30720-3014
Phone (706) 226-3311
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023677 | Other | GA | GA LICENSE |
| 208200000X | Other | GA | PROVIDER TYPE |
| 00245627A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- Loma Linda University School of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1501 Broadrick Dr
Suite 1
Dalton, GA 30720-3014
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 45 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1357 |
| Removal or shaving of skin growth | 93 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023677 | GA | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dalton Plastic Surgery | Plastic Surgery | Past | Accepting new patients |
| Dalton Plastic Surgery Center | Plastic Surgery | Past | Accepting new patients |
Interoperability endpoints
- rsherrill@directaddress.net
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Dalton, GA
- NPI 1740329077
-
- Surgical Physician Assistant
- Dalton, GA
- NPI 1861940462
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Plastic Surgery Physician
- Dalton, GA
- NPI 1659606408
-
- Plastic Surgery Physician
- Dalton, GA
- NPI 1356917199
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dalton, GA
- NPI 1528056066
-
- Psychiatric Hospital Unit
- Dalton, GA
- NPI 1760645782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268956800000",
"number": "1528007663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 BROADRICK DR",
"address_2": "SUITE 1",
"city": "DALTON",
"state": "GA",
"postal_code": "307203014",
"telephone_number": "706-226-3311",
"fax_number": "706-275-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 BROADRICK DR",
"address_2": "SUITE 1",
"city": "DALTON",
"state": "GA",
"postal_code": "307203014",
"telephone_number": "706-226-3311",
"fax_number": "706-275-8723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERRILL",
"first_name": "REGINALD",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2010-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "GA",
"license": "023677",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA LICENSE",
"identifier": "023677",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER TYPE",
"identifier": "208200000X",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00245627A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.