Individual provider Active NPI

Barbara Ruth Sheryll

  • Social Worker
  • Mattituck, NY
National Provider Identifier
1740845064
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
078159-1 Issued in NY
Practice address
7555 Main Rd
Mattituck, NY 11952-1516
Phone
(631) 298-8642
NPI assigned
May 2, 2019
Last updated
May 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X 0781591 NY
Clinical Social Worker 1041C0700X
Social Worker 104100000X 078159-1 NY Primary

Addresses

Primary practice location

7555 Main Rd
Mattituck, NY 11952-1516

Mailing address

2140 Bridge LN
Cutchogue, NY 11935-1307

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
078159-1NYMDSocial Worker
0781591NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1740845064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 BRIDGE LN",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119351307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521516",
            "telephone_number": "631-298-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERYLL",
        "first_name": "BARBARA",
        "middle_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0781591",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "078159-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.