Individual provider Active NPI

Sheridan R Hull, CNP

  • Nurse Practitioner
  • Westlake, OH
National Provider Identifier
1922195502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-07489 Issued in OH
Practice address
24165 Detroit Rd
Westlake, OH 44145-1516
Phone
(440) 250-3560
Fax
(440) 617-1815
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-07489 OH Primary

Addresses

Primary practice location

24165 Detroit Rd
Westlake, OH 44145-1516

Mailing address

3107 Lovers LN
Ravenna, OH 44266-8930
Phone (330) 296-2752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230807000684 VA Practitioner - Nurse Practitioner 0547268179
I20230825000948 WV Practitioner - Nurse Practitioner 0547268179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-07489OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Qofl Services LLC Nurse Practitioner Past Accepting new patients
Infinity Health Care, LLC PastSince Jul 1, 2015 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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922195502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 LOVERS LN",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442668930",
            "telephone_number": "330-296-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451516",
            "telephone_number": "440-250-3560",
            "fax_number": "440-617-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "SHERIDAN",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-07489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.