Active NPI
Emily Cousineau Sherburne, PA-C
- Physician Assistant
- Shawsville, VA
National Provider Identifier
1821259524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110-004338
- Practice address
- 6920 Roanoke Road
Shawsville, VA 24162 - Phone
- (540) 268-1400
- Fax
- (540) 268-1300
- NPI assigned
- Jun 24, 2008
- Last updated
- Sep 11, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110-004338 | VA | Primary |
Addresses
Primary practice location
6920 Roanoke Road
Shawsville, VA 24162
Mailing address
5975 Burnside Landing Dr
Burke, VA 22015-2518
Phone (504) 505-0316
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1081215 | Other | NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS | |
| 0110-004338 | Other | VA | COMMONWEALTH OF VIRGINIA |
| 0010-01365 | Other | NORTH CAROLINA MEDICAL BOARD |
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1821259524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5975 BURNSIDE LANDING DR",
"city": "BURKE",
"state": "VA",
"postal_code": "220152518",
"telephone_number": "504-505-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6920 ROANOKE ROAD",
"city": "SHAWSVILLE",
"state": "VA",
"postal_code": "24162",
"telephone_number": "540-268-1400",
"fax_number": "540-268-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERBURNE",
"first_name": "EMILY",
"middle_name": "COUSINEAU",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110-004338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS",
"identifier": "1081215",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF VIRGINIA",
"identifier": "0110-004338",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA MEDICAL BOARD",
"identifier": "0010-01365",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Shawsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.