Individual provider Active NPI

Sharon Paschal, PROVIDER

  • Community Health Worker
  • Texarkana, AR
National Provider Identifier
1679734081
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
167719783 Issued in AR
Practice address
2511 East 24TH Street Apt 1
Texarkana, AR 71854
Phone
(870) 774-0758
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Community Health Worker 172V00000X 167719783 AR Primary

Addresses

Primary practice location

2511 East 24TH Street Apt 1
Texarkana, AR 71854

Mailing address

2511 E 24TH St Apt 1
Texarkana, AR 71854-4058
Phone (870) 774-0758

Other identifiers 1

IdentifierTypeStateIssuer
167719783MedicaidAR

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

LicenseStateTypeSpecialty
167719783ARMDCommunity Health Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1679734081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 E 24TH ST APT 1",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718544058",
            "telephone_number": "870-774-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 EAST 24TH STREET APT 1",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "71854",
            "telephone_number": "870-774-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCHAL",
        "first_name": "SHARON",
        "credential": "PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AR",
            "license": "167719783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167719783",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.