Sherry J Secrest, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002601 Issued in VA

Practice address

1015 Spring Creek Pkwy
Zion Crossroads, VA 22942-7019

Phone

(434) 243-9466

Fax

(434) 243-9499

NPI assigned

May 14, 2007

Last updated

Oct 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sherry.secrest.1@14718.direct.athenahealth.com
• Direct secure messaging: ssecrest453737@direct.healthsystem.virginia.edu

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1588879142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007",
            "telephone_number": "434-295-1000",
            "fax_number": "434-972-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SPRING CREEK PKWY",
            "city": "ZION CROSSROADS",
            "state": "VA",
            "postal_code": "229427019",
            "telephone_number": "434-243-9466",
            "fax_number": "434-243-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECREST",
        "first_name": "SHERRY",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00749",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssecrest453737@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1015 Spring Creek Pkwy",
            "city": "Zion Crossroads",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229427019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisette P Rodriguez Camejo, M.D.
• Madison M Runnett
• Gertie B Sanders
• Sarah Elizabeth Schleich, DPT
• Jennifer Schmid, M.ED. CCC-SLP
• Sarah M Shapiro, MD
• Theresa Simmons, RPH, BCACP
• Megan L Soika, MS, OTRL
• Spring Creek Eyecare LLC
• Jennifer Graham Stancil, FNP-C

• Physician Assistant in Zion Crossroads, VA
• Providers in Zion Crossroads, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.