Individual provider Active NPI

Ellen Susan Sher, M.D., P.A.

  • Pediatric Endocrinology Physician
  • Dallas, TX
National Provider Identifier
1548292402
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
K5205 Issued in TX
Practice address
7777 Forest LN
Suite B-303
Dallas, TX 75230-2505
Phone
(972) 566-8833
Fax
(972) 566-8840
NPI assigned
Jul 7, 2006
Last updated
Jul 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X K5205 TX Primary

Addresses

Primary practice location

7777 Forest LN
Suite B-303
Dallas, TX 75230-2505

Mailing address

7777 Forest LN
Suite B-303
Dallas, TX 75230-2505
Phone (972) 566-8833

Other identifiers 1

IdentifierTypeStateIssuer
110737702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170210001054 TX Practitioner - Pediatric Medicine 2264715523 Practice locations: Dallas, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K5205TXMDPediatric Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1548292402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE B-303",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-8833",
            "fax_number": "972-566-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "SUITE B-303",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-8833",
            "fax_number": "972-566-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHER",
        "first_name": "ELLEN",
        "middle_name": "SUSAN",
        "credential": "M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "K5205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110737702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.