Individual provider Active NPI

Catherine McCollum Sherman

  • Family Nurse Practitioner
  • Canton, MS
National Provider Identifier
1669369062
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907521 Issued in MS
Practice address
112 Southlake Cir
Canton, MS 39046-5368
Phone
(601) 859-8550
NPI assigned
Jun 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907521 MS Primary

Addresses

Primary practice location

112 Southlake Cir
Canton, MS 39046-5368

Mailing address

118 Homestead Dr
Madison, MS 39110-6974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250703003769 MS Practitioner - Nurse Practitioner 4880108612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad Intermed Company LLCGroup PAC ID 6709245954, 42 clinicians

Practice addresses (Care Compare)

1265 Gluckstadt Rd
Suite B
Gluckstadt, MS 39110-7250
Phone (601) 859-8550

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quad Intermed Company LLC CurrentSince Jul 1, 2025 Accepting new patients
Quad Intermed Company LLC CurrentSince Jul 1, 2025 Accepting new patients
Quad Intermed Company LLC Current Accepting new patients
Quad Intermed Company LLC CurrentSince Jul 1, 2025 Accepting new patients
Quad Intermed Company LLC PastSince Sep 28, 2025 Accepting new patients
Quad Intermed Company LLC PastSince Jul 1, 2025 Accepting new patients
Bespoke Aesthetics and Plastic Surgery PastSince Nov 8, 2025 Accepting new patients

Locations

112 Southlake Cir
Canton, MS 39046
Phone (601) 859-8550

1265 Gluckstadt Rd
Ste B
Gluckstadt, MS 39110
Phone (601) 859-8550

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717

4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1669369062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 HOMESTEAD DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SOUTHLAKE CIR",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465368",
            "telephone_number": "601-859-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "CATHERINE",
        "middle_name": "MCCOLLUM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.