Sherri S Vazales, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301074823 Issued in MI

Practice address

14695 Park Ave Ste a
Charlevoix, MI 49720

Phone

(231) 547-2812

NPI assigned

May 18, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1780637769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-392-0421",
            "fax_number": "231-935-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14695 PARK AVE STE A",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "49720",
            "telephone_number": "231-547-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4170 Cedar Bluff Drive",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497707627",
            "country_code": "US",
            "telephone_number": "231-487-6700 x208",
            "fax_number": "231-487-0303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZALES",
        "first_name": "SHERRI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301074823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070015180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4230205",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tova Rogers MD Mfa PLLC
• Jilaine Towne-Patton, LPC
• Adam John Tsaloff
• Mark Leroy Vanderweide, CRNA
• Stephanie L Vanniman, LMSW
• Meghann Vincent
• Amy L Vipond, PTA
• Steven A Voci, O.D.
• Jennifer Vollmer, LPC
• Alexandra Bokor Waha, LMSW

• Dermatology Physician in Charlevoix, MI
• Providers in Charlevoix, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.