Active NPI
Sherery Roshelle Brown
- Adolescent and Children Mental Health Clinic/Center
- Martinsville, VA
National Provider Identifier
1679081103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent and Children Mental Health Clinic/Center
- Practice address
- 916 Brookdale St Ste 2
Martinsville, VA 24112-3105 - Phone
- (276) 790-3341
- Fax
- (276) 790-3167
- NPI assigned
- Jan 18, 2018
- Last updated
- Jan 18, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | VA | Primary |
Addresses
Primary practice location
916 Brookdale St Ste 2
Martinsville, VA 24112-3105
Mailing address
PO Box 3542
Martinsville, VA 24115-3542
Phone (276) 618-4605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0242569520 | Medicaid | VA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart Two Heart Rehab Support Services | Current | Accepting new patients | |
| H2H Transportation Services, LLC | Current | Accepting new patients | |
| R & E Transportation, LLC | Current | Accepting new patients |
Locations
916 Brookdale St
Ste 2
Martinsville, VA 24112
Phone (276) 790-3341
Organizations & group practices 3
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.
-
- Secured Medical Transport (VAN)
- Martinsville, VA
- NPI 1386532976
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Martinsville, VA
- NPI 1265919054
-
- Non-emergency Medical Transport (VAN)
- Martinsville, VA
- NPI 1427651603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1679081103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3542",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241153542",
"telephone_number": "276-618-4605",
"fax_number": "276-790-3167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 BROOKDALE ST STE 2",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241123105",
"telephone_number": "276-790-3341",
"fax_number": "276-790-3167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHERERY",
"middle_name": "ROSHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-18",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0242569520",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.