Sherrill Tracy, MD
Individual provider Active NPI Family Medicine Physician · Gorham, NH
NPI 1740282136 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1740282136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 6910 (NH)
- Practice address
- 2 Broadway Street
Gorham, NH 03581 - Phone
- (603) 466-2741
- Fax
- (603) 466-2953
- NPI assigned
- Aug 15, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6910 | NH | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 6910 | NH | Yes |
Addresses
Primary practice location
2 Broadway Street
Gorham, NH 03581
Mailing address
133 Pleasant Street
Berlin, NH 03570
Phone (603) 752-2040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6910 | Other | NH | STATE LICENSE # |
| 81083242 | Medicaid | NH | |
| P00120775 | Other | RAILROAD MEDICARE | |
| 5635115001 | Other | NH | CIGNA HEALTHCARE |
| 0104864YPNH02 | Other | NH | ANTHEM BC/BS |
Other providers in Gorham, NH
- Susan Martlock-J&S Care Enterprise
- Thomas Temme
- Maria Lynn Therriault
- Gary Tilton
- Town of Gorham
- United Podiatry PLLC
- Wal-Mart Stores East LP
- Wal-Mart Stores East, L.P.
- Emily Kate York
All providers in Gorham, NH · Family Medicine Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.