Stacy Jo Sherwood, PMHNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19809 Issued in CA

Practice address

725 Washburn Way
Klamath Falls, OR 97603-3648

Phone

(541) 883-1030

Fax

(541) 884-2338

NPI assigned

Dec 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Klamath Child and Family Treatment CenterGroup PAC ID 2062642507, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Klamath Child and Family Treatment Center

  dba Klamath Youth Development Center

  • Voluntary or Charitable Agency
  • Klamath Falls, OR
  • NPI 1902830524
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1730481243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 ELDORADO AVE.",
            "city": "KLAMTH FALLS",
            "state": "OR",
            "postal_code": "976016418",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WASHBURN WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976033648",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "STACY JO",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223354",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Shaw
• Julie Sheasby
• Cheyenne Marie Shellito
• Kimberly Sherman
• Skyler Danee Sherrill
• Candice Phyllis Love Shidler, QMHA
• Emily Suzanne Shields
• Brandi Shilling
• Nicholas Shipler
• Lyle Stephen Shrifter, MSW.

• Family Nurse Practitioner in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.