Individual provider Active NPI

Christina Renee Sherrod, MD

  • Pediatrics Physician
  • Lake Worth, TX
National Provider Identifier
1932422383
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P0480 Issued in TX
Practice address
3900 Boat Club Rd
Lake Worth, TX 76135-3201
Phone
(817) 237-7161
NPI assigned
Mar 11, 2010
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P0480 TX Primary

Addresses

Primary practice location

3900 Boat Club Rd
Lake Worth, TX 76135-3201

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csherrod142699@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000324 TX Practitioner - Pediatric Medicine 1850560061 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics CurrentSince Jul 20, 2020 Accepting new patients
Texas Scottish Rite Hospital for Crippled Children CurrentSince Aug 26, 2019 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Jul 20, 2020 Accepting new patients
Texas Scottish Rite Hospital for Crippled Children Past Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone 4698572222 ext. 72222

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

3900 Boat Club Rd
Lake Worth, TX 76135
Phone (817) 237-7161

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: csherrod142699@cookchildrens.direct-ci.com

Organizations & group practices 4

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": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1932422383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BOAT CLUB RD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353201",
            "telephone_number": "817-237-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERROD",
        "first_name": "CHRISTINA",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2021-04-09",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P0480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csherrod142699@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "3900 Boat Club Rd",
            "city": "Lake Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761353201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

Verify at the official NPI Registry.