Active NPI
Miranda Sherwood, PA-C
- Medical Physician Assistant
- Dearborn, MI
National Provider Identifier
1649840299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601009893
- Practice address
- 5901 Chase Rd Ste 110
Dearborn, MI 48126-0900 - Phone
- (313) 581-9446
- NPI assigned
- Jun 27, 2021
- 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 | 5601009893 | MI | Primary |
Addresses
Primary practice location
5901 Chase Rd Ste 110
Dearborn, MI 48126-0900
Mailing address
5901 Chase Rd Ste 110
Dearborn, MI 48126-0900
Phone (313) 581-9446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1123344567 | Other | NOT APPLICABLE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Amazingcharts | ||
| CONNECT URL | Amazingcharts |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601009893 | MI | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624752000000",
"number": "1649840299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 CHASE RD STE 110",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481260900",
"telephone_number": "313-581-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 CHASE RD STE 110",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481260900",
"telephone_number": "313-581-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERWOOD",
"first_name": "MIRANDA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-27",
"last_updated": "2021-06-27",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601009893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOT APPLICABLE",
"identifier": "1123344567",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Amazingcharts",
"affiliation": "N",
"address_1": "5901 Chase Rd Ste 110",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481260900",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Amazingcharts",
"affiliation": "N",
"address_1": "5901 Chase Rd Ste 110",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481260900",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.