Justin D Sterett, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25799 Issued in NE

Practice address

27 Somdg 208 W. Casablanca Ave BLDG 1400
Cannon Afb, NM 88103

Phone

(575) 784-0287

NPI assigned

Jun 22, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1568690113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FAIRWAY TER",
            "address_2": "APT. 18",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881013085",
            "telephone_number": "616-635-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SOMDG 208 W. CASABLANCA AVE BLDG 1400",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERETT",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "25799",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard James Serkowski, DO, MPH, CPE
• June Ellen Shepherd, PH.D.
• Luke Smith, DMD
• Nicholas Kenneth Smythe III, PH.D. IN PROGRESS
• Andrew Springstead
• Adam John Taylor, LCSW
• Andrea Theye, PSY. D.
• Kathleen Thomas, DMD
• Edwin Josue Toro Alvarado, MSW
• Donald Joseph Trigg, PA-C

• General Practice Physician in Cannon Afb, NM
• Providers in Cannon Afb, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.