Active NPI
Corey Sheremeto, DO
- Surgery Physician
- Hephzibah, GA
National Provider Identifier
1659003705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 14308
- Practice address
- 3580 Whithorn CT
Hephzibah, GA 30815-6526 - Phone
- (816) 269-6837
- NPI assigned
- Jun 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 14308 | GA | Primary |
Addresses
Primary practice location
3580 Whithorn CT
Hephzibah, GA 30815-6526
Mailing address
3580 Whithorn CT
Hephzibah, GA 30815-6526
Phone (816) 269-6837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220711000225 | GA | Order and Referring Only - General Surgery | 0547640369 | |
| I20240717000243 | GA | Order and Referring Only - Interventional Radiology | 0547640369 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14308 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1659003705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3580 WHITHORN CT",
"city": "HEPHZIBAH",
"state": "GA",
"postal_code": "308156526",
"telephone_number": "816-269-6837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 WHITHORN CT",
"city": "HEPHZIBAH",
"state": "GA",
"postal_code": "308156526",
"telephone_number": "816-269-6837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEREMETO",
"first_name": "COREY",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-28",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "GA",
"license": "14308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hephzibah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.