Keenon Sherrell, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M-09894 Issued in NM

Practice address

100 W Griggs Ave
Las Cruces, NM 88001-1234

Phone

(575) 647-2800

Fax

(575) 647-2898

NPI assigned

Dec 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

La Clinica de Familia IncorporatedGroup PAC ID 6305745191, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1528424397
  Medicare reassignment Care Compare group NPD
• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1134917040
  NPD
• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1740286863
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1992276273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011234",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRELL",
        "first_name": "KEENON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-09894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie Janee Shelton, MOTR/L
• Bryant Mario Shepard
• Bradley Mark Shepherd, D.C.
• Reed Sheridan, PHARM.D.
• Judith Myers Sherman, MD
• Claire Ashburn Shervanick, MD
• San Curtis Shields, CNP
• Felicia Ann Shipp, NURSE PRACTITIONER
• Chetan Shivaram, DDS
• Kristi Shoaf, OT

• Social Worker in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.