Individual provider Active NPI

Carolyn J Sharrock-Dorsten, DPM

  • Podiatrist
  • Bryan, OH
National Provider Identifier
1659325157
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003108 Issued in OH
Practice address
442 W High St Ste 3
Bryan, OH 43506-1681
Phone
(419) 636-4517
Fax
(419) 636-6438
NPI assigned
May 19, 2006
Last updated
Dec 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36003108 OH Primary

Addresses

Primary practice location

442 W High St Ste 3
Bryan, OH 43506-1681

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other identifiers 2

IdentifierTypeStateIssuer
P00223135OtherOHRAILROAD
2199740MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address csharrockdorsten11216@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000268 OH Practitioner - Podiatry 6406752906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Community Health Associates, Inc.Group PAC ID 0941114250, 100 clinicians

Practice addresses (Care Compare)

433 W High St
Bryan, OH 43506-1690
Phone (419) 630-2028

442 W High St
Bryan, OH 43506-1681
Phone (260) 266-8210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
71.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue324
Removal or shaving of skin growth63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36003108OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: csharrockdorsten11216@direct.parkviewexchange.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Parkview Bryan HospitalBryan, OH, CCN 360121 Hospital Corporate Officer Jan 1, 2022
Parkview Montpelier HospitalMontpelier, OH, CCN 361327 Hospital Corporate Director Jan 1, 2022
Parkview Montpelier HospitalMontpelier, OH, CCN 36Z327 Hospital Other Jan 1, 2022

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1659325157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 W HIGH ST STE 3",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061681",
            "telephone_number": "419-636-4517",
            "fax_number": "419-636-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARROCK-DORSTEN",
        "first_name": "CAROLYN",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00223135",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2199740",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csharrockdorsten11216@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "442 W High St",
            "city": "Bryan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435061681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "442 W High St",
            "city": "Bryan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435061681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "442 W High St",
            "city": "Bryan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435061681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.