Individual provider Active NPI

Sharon Lee Reed, CERTIFIED MASTECTOMY

  • Prosthetic/Orthotic Supplier
  • Traverse City, MI
National Provider Identifier
1619022829
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Practice address
2615 Hammond Highlands Drive
Traverse City, MI 49686-9141
Phone
(231) 922-5982
Fax
(231) 922-5982
NPI assigned
Jan 25, 2007
Last updated
Nov 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X MI Primary

Addresses

Primary practice location

2615 Hammond Highlands Drive
Traverse City, MI 49686-9141

Mailing address

2615 Hammond Highlands Drive
Traverse City, MI 49686-9141
Phone (231) 922-5982

Other identifiers 2

IdentifierTypeStateIssuer
2867263MedicaidMI
0540050256OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Lee Reed Past Accepting new patients

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1619022829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 HAMMOND HIGHLANDS DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869141",
            "telephone_number": "231-922-5982",
            "fax_number": "231-922-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 HAMMOND HIGHLANDS DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869141",
            "telephone_number": "231-922-5982",
            "fax_number": "231-922-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CERTIFIED MASTECTOMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2867263",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0540050256",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.