Individual provider Active NPI

Joshua W Sharp

  • Family Nurse Practitioner
  • Pine Knot, KY
National Provider Identifier
1689282642
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015666 Issued in KY
Practice address
57 Hogue Rd
Pine Knot, KY 42635-7003
Phone
(606) 354-9444
Fax
(606) 354-9449
NPI assigned
Jul 16, 2020
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3015666 KY Primary
Registered Nurse 163W00000X 238134 TN

Addresses

Primary practice location

57 Hogue Rd
Pine Knot, KY 42635-7003

Mailing address

PO Box 300
Pine Knot, KY 42635-0300
Phone (606) 354-9444

Other practice location 1

71 Medical Ln
Whitley City, KY 42653-4216
Phone (606) 376-7212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210121002014 KY Practitioner - Nurse Practitioner 2365856945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Family Clinic, PLLCGroup PAC ID 0749426047, 3 clinicians
Southfork Medical Clinic PLLCGroup PAC ID 7012815616, 4 clinicians

Practice addresses (Care Compare)

57 Hogue Rd
Pine Knot, KY 42635-7003
Phone (606) 376-7212

PO Box
Whitley City, KY 42653

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238134TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southfork Medical Clinic PLLC CurrentSince Jan 18, 2021 Accepting new patients
Cumberland Family Clinic, PLLC CurrentSince Jan 18, 2021 Accepting new patients
Southfork Medical Clinic PLLC Past Accepting new patients

Locations

57 Hogue Rd
Pine Knot, KY 42635
Phone (606) 354-9444

71 Medical Ln
Whitley City, KY 42653
Phone (606) 376-7212

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.

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1689282642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "PINE KNOT",
            "state": "KY",
            "postal_code": "426350300",
            "telephone_number": "606-354-9444",
            "fax_number": "606-354-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 HOGUE RD",
            "city": "PINE KNOT",
            "state": "KY",
            "postal_code": "426357003",
            "telephone_number": "606-354-9444",
            "fax_number": "606-354-9449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Medical Ln",
            "address_purpose": "LOCATION",
            "city": "Whitley City",
            "state": "KY",
            "postal_code": "426534216",
            "country_code": "US",
            "telephone_number": "606-376-7212",
            "fax_number": "606-376-7216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JOSHUA",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015666",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "238134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Knot, KY

Sources for this page

Verify at the official NPI Registry.