Katy Sheridan MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3723 Issued in AK

Legal business name

KATY SHERIDAN MD PC

Practice address

154 W Marydale Ave
Soldotna, AK 99669-7501

Phone

(907) 260-3121

Fax

(907) 260-4022

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Katy Marie Sheridan, M.D.NPI 1518983246

Title

Owner

Phone

(907) 260-3121

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katy Marie Sheridan, M.D.

  • Family Medicine Physician
  • Soldotna, AK
  • NPI 1518983246
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Wooley, MD

  • Student in an Organized Health Care Education/Training Program
  • Klamath Falls, OR
  • NPI 1972065910

  AK

  Medicare reassignment Care Compare group NPD
• Kali Saxton-Shaw, PA-C

  • Physician Assistant
  • Soldotna, AK
  • NPI 1255784484
  Medicare reassignment

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1992814818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 W MARYDALE AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697501",
            "telephone_number": "907-260-3121",
            "fax_number": "907-260-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 W MARYDALE AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697501",
            "telephone_number": "907-260-3121",
            "fax_number": "907-260-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY SHERIDAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "KATY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-260-3121",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581953",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kamauoha
• Susan Kamauoha
• Kamuck Incorporated
• Lori Kempf Karvonen
• John Edward Kasukonis, Jr., D.O.
• Hannah Bryn Katzenberger
• Michelle Kearby, OTR/L
• Kristen Keeley, MD
• Keen Eye Care Assisted Living Inc
• Kristen Nicole Keeton, OTR/L

• Family Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.