Individual provider Active NPI

Sherry Ann Siegelman, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Russellville, KY
National Provider Identifier
1861062259
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3016309 Issued in KY
Practice address
1497 Nashville St
Russellville, KY 42276-8850
Phone
(270) 726-9568
Fax
(270) 726-9570
NPI assigned
Jun 28, 2021
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3016309 KY Primary

Addresses

Primary practice location

1497 Nashville St
Russellville, KY 42276-8850

Mailing address

480 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210805001436 KY Practitioner - Nurse Practitioner 3971907478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1497 Nashville St
Russellville, KY 42276-8850
Phone (270) 726-9568

975 Hopkinsville Rd
Russellville, KY 42276-9774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Western Kentucky, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Community Health Centers of Western Kentucky, Inc. CurrentSince Sep 1, 2021 Accepting new patients
Community Health Centers of Western Kentucky Inc Past Accepting new patients

Locations

480 Hopkinsville St
Greenville, KY 42345
Phone (270) 338-5777

1497 Nashville St
Russellville, KY 42276
Phone (270) 726-1266

Organizations & group practices 3

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1861062259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-338-5777",
            "fax_number": "270-338-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 NASHVILLE ST",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768850",
            "telephone_number": "270-726-9568",
            "fax_number": "270-726-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGELMAN",
        "first_name": "SHERRY",
        "middle_name": "ANN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3016309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, KY

Sources for this page

Verify at the official NPI Registry.