Individual provider Active NPI

Sherri W Osborne, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, NC
National Provider Identifier
1841514486
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5004701 Issued in NC
Practice address
4417 Springbrook Dr
Burlington, NC 27215-7021
Phone
(910) 275-4605
Fax
(844) 835-3565
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004701 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5004701 NC Primary

Addresses

Primary practice location

4417 Springbrook Dr
Burlington, NC 27215-7021

Mailing address

4417 Springbrook Dr
Burlington, NC 27215-7021
Phone (910) 275-4605

Other identifiers 1

IdentifierTypeStateIssuer
6113098MedicaidNC

Other names 1

  • Sherri Lynn Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506001055 NC Practitioner - Nurse Practitioner 3274661590 Practice locations: Stoneville, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004701NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Past Accepting new patients
Recovery Innovations, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1841514486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 SPRINGBROOK DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157021",
            "telephone_number": "910-275-4605",
            "fax_number": "844-835-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 SPRINGBROOK DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157021",
            "telephone_number": "910-275-4605",
            "fax_number": "844-835-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "SHERRI",
        "middle_name": "W",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004701",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5004701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6113098",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRI",
            "last_name": "WILSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.