Individual provider Active NPI

Sherline Pierre, MSW

  • Clinical Social Worker
  • Kissimmee, FL
National Provider Identifier
1568752699
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1809 Hudson Dr
Kissimmee, FL 34759-5379
Phone
(917) 833-5159
Fax
(863) 496-1871
NPI assigned
Apr 11, 2011
Last updated
Apr 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X FL Primary

Addresses

Primary practice location

1809 Hudson Dr
Kissimmee, FL 34759-5379

Mailing address

1809 Hudson Dr
Kissimmee, FL 34759-5379
Phone (917) 833-5159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529001641 FL Practitioner - Clinical Social Worker 5991147423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC CurrentSince Apr 20, 2024 Accepting new patients

Locations

500 Vonderburg Dr
Ste 215W
Brandon, FL 33511
Phone (813) 662-3777

5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

Interoperability endpoints

  • Direct secure messaging: sherline.pierre.3@29601.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1568752699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 HUDSON DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347595379",
            "telephone_number": "917-833-5159",
            "fax_number": "863-496-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 HUDSON DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347595379",
            "telephone_number": "917-833-5159",
            "fax_number": "863-496-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "SHERLINE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.