Individual provider Active NPI

Neelu Sherpa

  • Dentist
  • Memphis, TN
National Provider Identifier
1699464248
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12227 Issued in TN
Practice address
2953 Broad Ave
Memphis, TN 38112-2957
Phone
(901) 842-3171
NPI assigned
May 1, 2023
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12227 TN Primary

Addresses

Primary practice location

2953 Broad Ave
Memphis, TN 38112-2957

Mailing address

2953 Broad Ave
Memphis, TN 38112-2957
Phone (901) 842-3174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604001049 TN Practitioner - Dentist 4789155359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1200 Synergy Way
Holly Hill, FL 32117-2502

2670 Union Ave Ext
Suite 1000
Memphis, TN 38112-4416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12227TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Community Health Services, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1699464248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2953 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122957",
            "telephone_number": "901-842-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2953 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122957",
            "telephone_number": "901-842-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERPA",
        "first_name": "NEELU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.