Sheryl L Mitchell, DNPAPRN FNPBC ACNPBC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3711 Issued in SC

Practice address

3700 Forest Dr Ste 200
Columbia, SC 29204-4010

Phone

(803) 799-1922

Fax

(803) 799-6729

NPI assigned

Dec 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sheryl L.Ynn Montgomery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Pee Dee Emergency Physicians

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1669667606
  NPD (past)

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1619112695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FOREST DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044010",
            "telephone_number": "803-799-1922",
            "fax_number": "803-799-6729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 Blanding St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012967",
            "country_code": "US",
            "telephone_number": "803-256-2500",
            "fax_number": "803-758-1726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHERYL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DNPAPRN FNPBC ACNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2021-06-14",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA39635684",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1648",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERYL",
            "last_name": "MONTGOMERY",
            "middle_name": "L.YNN",
            "credential": "DNPAPRN FNPBC ACNPBC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Mitchell, DO
• Raymond E Mitchell
• Regina Katherine Mitchell, NP
• Robert Edward Mitchell III, APRN
• Shayquell Mitchell
• Tomkies H Mitchell, RPH
• Shalini Mittal, M.D.
• Charles M Miyaji, DMD
• Sharon Miyata, LMFT
• Mobi Care Medical Transport, LLC

• Family Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.