Individual provider Active NPI

Robin Sherman

  • Clinical Social Worker
  • South Portland, ME
National Provider Identifier
1912372830
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC15572 Issued in ME
Practice address
280B Gannett Dr
South Portland, ME 04106-6940
Phone
(207) 828-0048
Fax
(207) 874-7697
NPI assigned
Dec 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC15572 ME Primary

Addresses

Primary practice location

280B Gannett Dr
South Portland, ME 04106-6940

Mailing address

280B Gannett Dr
South Portland, ME 04106-6940
Phone (207) 828-0048

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

LicenseStateTypeSpecialty
MC15572MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Port Resources PastSince Oct 3, 2014 Accepting new patients

Organizations & group practices 1

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1912372830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280B GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066940",
            "telephone_number": "207-828-0048",
            "fax_number": "207-874-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280B GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066940",
            "telephone_number": "207-828-0048",
            "fax_number": "207-874-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "ROBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC15572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.