Individual provider Active NPI

Sherilyn Michelle Donnelly, NP-C

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1689911414
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-123490 Issued in AL
Practice address
3065 Dauphin St
Mobile, AL 36606-4040
Phone
(251) 271-7017
Fax
(251) 220-5536
NPI assigned
Jan 14, 2013
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 1-123490 AL Primary
Registered Nurse 163W00000X 1-123490 AL

Addresses

Primary practice location

3065 Dauphin St
Mobile, AL 36606-4040

Mailing address

PO Box 746063
Atlanta, GA 30374-6063
Phone (312) 733-9730

Other practice location 1

24980 State St
Elberta, AL 36530-2573
Phone (251) 986-7301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20130516000209 AL Practitioner - Nurse Practitioner 4284871906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group of Alabama, LLCGroup PAC ID 9133538432, 28 clinicians

Practice addresses (Care Compare)

3065 Dauphin St
Mobile, AL 36606-4040
Phone (251) 271-7017

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-123490ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elberta Clinic, PC CurrentSince May 1, 2016 Accepting new patients
Oak Street Health Physicians Group of Alabama, LLC Family CurrentSince Sep 26, 2024 Accepting new patients

Locations

1687 Center Point Pkwy
Ste 121
Birmingham, AL 35215
Phone (205) 557-7022

24980 State St
Elberta, AL 36530
Phone (251) 201-7667

3065 Dauphin St
Mobile, AL 36606
Phone (251) 271-7017

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": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1689911414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746063",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746063",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064040",
            "telephone_number": "251-271-7017",
            "fax_number": "251-220-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24980 State St",
            "address_purpose": "LOCATION",
            "city": "Elberta",
            "state": "AL",
            "postal_code": "365302573",
            "country_code": "US",
            "telephone_number": "251-986-7301",
            "fax_number": "251-986-5927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SHERILYN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-123490",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-123490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.