Active NPI
Jerome a Sherard MD PC
- Pediatrics Physician
- Chattanooga, TN
National Provider Identifier
1962620302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- JEROME A SHERARD MD PC
- Practice address
- 340 N Holtzclaw Ave
Chattanooga, TN 37404-2305 - Phone
- (423) 624-3555
- Fax
- (423) 624-7030
- NPI assigned
- Apr 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerome A Sherard, MD
- Title
- Sole Proprietor
- Phone
- (423) 624-3555
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary | ||
| General Practice Physician | 208D00000X |
Addresses
Primary practice location
340 N Holtzclaw Ave
Chattanooga, TN 37404-2305
Mailing address
340 N Holtzclaw Ave
Chattanooga, TN 37404-2305
Phone (423) 624-3555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300040361B | Medicaid | GA | |
| 3015325 | Medicaid | TN |
National Provider Directory
National Provider DirectoryLocations
340 N Holtzclaw Ave
Chattanooga, TN 37404
Phone (423) 624-3555
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Chattanooga, TN
- NPI 1982637625
-
- Family Nurse Practitioner
- Chattanooga, TN
- NPI 1326303934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1290124800000",
"number": "1962620302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 N HOLTZCLAW AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374042305",
"telephone_number": "423-624-3555",
"fax_number": "423-624-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 N HOLTZCLAW AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374042305",
"telephone_number": "423-624-3555",
"fax_number": "423-624-7030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEROME A SHERARD MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2010-11-19",
"status": "A",
"authorized_official_last_name": "SHERARD",
"authorized_official_first_name": "JEROME",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "SOLE PROPRIETOR",
"authorized_official_telephone_number": "423-624-3555",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300040361B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3015325",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.