Active NPI
Sherri K Doll, CNP
- Nurse Practitioner
- Bismarck, ND
National Provider Identifier
1700930054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R23751
- Practice address
- 900 E Broadway Ave
Bismarck, ND 58501-4520 - Phone
- (701) 530-7000
- Fax
- (701) 530-8842
- NPI assigned
- Jan 23, 2007
- Last updated
- Oct 7, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R23751 | ND | Primary |
Addresses
Primary practice location
900 E Broadway Ave
Bismarck, ND 58501-4520
Mailing address
900 E Broadway Ave
P.O. Box 997
Bismarck, ND 58501-4520
Phone (701) 530-7000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19564 | Medicaid | ND | |
| 500005981 | Other | ND | RR MEDICARE |
Other names 1
- Sherri K Jacob
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Glasgow, MT
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1700930054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 E BROADWAY AVE",
"address_2": "P.O. BOX 997",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014520",
"telephone_number": "701-530-7000",
"fax_number": "701-530-8842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E BROADWAY AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014520",
"telephone_number": "701-530-7000",
"fax_number": "701-530-8842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLL",
"first_name": "SHERRI",
"middle_name": "K",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ND",
"license": "R23751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "19564",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "500005981",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHERRI",
"last_name": "JACOB",
"middle_name": "K",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.