Active NPI
Sherrie J Conrad, PAC
- Medical Physician Assistant
- Woodland, CA
National Provider Identifier
1639199516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA17010
- Practice address
- 515 Fairchild CT
Woodland, CA 95695-5164 - Phone
- (530) 668-2600
- Fax
- (530) 669-3661
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA17010 | CA | Primary |
Addresses
Primary practice location
515 Fairchild CT
Woodland, CA 95695-5164
Mailing address
3400 Data Dr
Attn Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956
Other names 1
- Miss Sherrie J Eager
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1639199516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"address_2": "ATTN CREDENTIALING/PAYER ENROLLMENT",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 FAIRCHILD CT",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956955164",
"telephone_number": "530-668-2600",
"fax_number": "530-669-3661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "SHERRIE",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA17010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHERRIE",
"last_name": "EAGER",
"middle_name": "J",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.