Active NPI
Sherese Nicole Bearden
- Licensed Practical Nurse
- South Euclid, OH
National Provider Identifier
1770175176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 117980
- Practice address
- 1524 Genesee Rd
South Euclid, OH 44121-2753 - Phone
- (216) 860-3120
- NPI assigned
- Feb 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 117980 | OH | Primary |
Addresses
Primary practice location
1524 Genesee Rd
South Euclid, OH 44121-2753
Mailing address
1524 Genesee Rd
South Euclid, OH 44121-2753
Phone (216) 860-3120
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | sheresebearden@yahoo.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 117980 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612656000000",
"number": "1770175176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1524 GENESEE RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441212753",
"telephone_number": "216-860-3120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1524 GENESEE RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441212753",
"telephone_number": "216-860-3120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARDEN",
"first_name": "SHERESE",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-07",
"last_updated": "2021-02-07",
"certification_date": "2021-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "117980",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "sheresebearden@yahoo.com",
"affiliation": "N",
"address_1": "1524 Genesee Rd",
"city": "South Euclid",
"state": "OH",
"country_code": "US",
"postal_code": "441212753",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in South Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.