Individual provider Active NPI

Serena R Sherron, DO

  • Pediatrics Physician
  • Corpus Christi, TX
National Provider Identifier
1760474126
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K3464 Issued in TX
Practice address
3533 S Alameda St
#303, Joseph M. Sloan BLDG.
Corpus Christi, TX 78411-1721
Phone
(361) 853-3222
Fax
(361) 853-7311
NPI assigned
Aug 21, 2005
Last updated
Oct 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K3464 TX Primary

Addresses

Primary practice location

3533 S Alameda St
#303, Joseph M. Sloan BLDG.
Corpus Christi, TX 78411-1721

Mailing address

3533 S Alameda St
Ste 303
Corpus Christi, TX 78411-1721
Phone (361) 853-3222

Other identifiers 1

IdentifierTypeStateIssuer
092196701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160708000049 TX Practitioner - Pediatric Medicine 8527283092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Pediatrics, P.a. Pediatrics CurrentSince Jun 22, 2016 Accepting new patients
Abc Pediatrics, P.a. Pediatrics Past Accepting new patients

Locations

3533 S Alameda St
#303
Corpus Christi, TX 78411
Phone (361) 853-3222

3533 S Alameda St
#303J
Corpus Christi, TX 78411
Phone (361) 853-3222

3533 S Alameda St
Ste 303
Corpus Christi, TX 78411
Phone (361) 853-3222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13003/brand/1/csg/1/fhir/r4

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": "1124582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1760474126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "address_2": "STE 303",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-853-3222",
            "fax_number": "361-561-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "address_2": "#303, JOSEPH M. SLOAN BLDG.",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-853-3222",
            "fax_number": "361-853-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRON",
        "first_name": "SERENA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-21",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K3464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092196701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.