Individual provider Active NPI

Paul Theodore Sherman, P.T.

  • Physical Therapist
  • Anacortes, WA
National Provider Identifier
1649332065
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006126 Issued in WA
Practice address
1813 O Ave
Sherman Physical Therapy
Anacortes, WA 98221-2344
Phone
(360) 588-8075
Fax
(360) 588-0406
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00006126 WA Primary

Addresses

Primary practice location

1813 O Ave
Sherman Physical Therapy
Anacortes, WA 98221-2344

Mailing address

1813 O Ave
Anacortes, WA 98221-2344
Phone (360) 588-8075

Other identifiers 1

IdentifierTypeStateIssuer
7103484MedicaidWA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fidalgo Functional Physical Therapy Physical Therapist PastSince May 20, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649332065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 O AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212344",
            "telephone_number": "360-588-8075",
            "fax_number": "360-588-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 O AVE",
            "address_2": "SHERMAN PHYSICAL THERAPY",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212344",
            "telephone_number": "360-588-8075",
            "fax_number": "360-588-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "PAUL",
        "middle_name": "THEODORE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7103484",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.