Individual provider Active NPI

Sherry Elizabeth McIlwain, WHNP-BC

  • Women's Health Nurse Practitioner
  • Palestine, TX
National Provider Identifier
1639419880
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
735949 Issued in TX
Practice address
115 Medical Dr
Palestine, TX 75801-4781
Phone
(903) 723-8554
NPI assigned
Feb 26, 2013
Last updated
Feb 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 735949 TX Primary

Addresses

Primary practice location

115 Medical Dr
Palestine, TX 75801-4781

Mailing address

4039 Angel Trumpet
San Antonio, TX 78259-2357
Phone (210) 347-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20130618000725 TX Practitioner - Nurse Practitioner 3375782618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Specialty PhysiciansGroup PAC ID 6305901927, 59 clinicians

Practice addresses (Care Compare)

115 Medical Dr
Palestine, TX 75801-4781
Phone (903) 723-8554

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.93 of 100Reported as group
Promoting interoperability
78
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
735949TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Specialty Physicians Women's Health Current Accepting new patients
Texas Specialty Physicians CurrentSince Oct 31, 2017 Accepting new patients

Locations

514 S Bonham St
Ste D
Mexia, TX 76667
Phone (254) 562-5961

115 Medical Dr
Palestine, TX 75801
Phone (903) 703-8554

Interoperability endpoints

  • Direct secure messaging: sherry.mcilwain.1@20210.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1639419880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 ANGEL TRUMPET",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592357",
            "telephone_number": "210-347-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-723-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "SHERRY",
        "middle_name": "ELIZABETH",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "735949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.