SHERRILL TRACY (NPI# 1740282136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740282136 |
| Entity Type | Individual |
| Full Name | SHERRILL TRACY |
| Credential | MD |
| Practice Address |
2 Broadway Street Gorham NH 03581 |
| Mailing Address |
133 Pleasant Street Berlin NH 03570 |
| Practice Telephone | 6034662741 |
| Practice Fax Number | 6034662953 |
| Mailing Telephone | 6037522040 |
| Mailing Fax Number | 6037527797 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2015-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 6910 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P00120775 | 01 | |
| NH | 81083242 | 05 | |
| NH | STATE LICENSE # | 6910 | 01 |
| NH | ANTHEM BC/BS | 0104864YPNH02 | 01 |
| FEDERAL DEA# | AT2218370 | 01 | |
| NH | CIGNA HEALTHCARE | 5635115001 | 01 |
| Street Address |
2 BROADWAY STREET |
| City | GORHAM |
| State | NH |
| Zip Code | 03581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073040234 | Maryanne Eileen Christiansen | Physician Assistant | 2 Broadway Street, Gorham, NH 03581 | 2017-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932456530 | Amy Lynn Galipeau | Hearing Instrument Specialist | 20 Glen Rd, Gorham, NH 03581 | 2012-08-14 |
| 1003070855 | Derek C Eastman | Physical Therapist | 38 Alpine Street, Gorham, NH 03581 | 2008-07-10 |
| 1003097668 | Todd Butler | Speech-Language Pathologist | 6 Howland Avenue, Gorham, NH 03581 | 2007-11-23 |
| 1235354978 | Nancy Gordon | Physical Therapist | 25 Mt. Carter Road, Gorham, NH 03581 | 2007-04-16 |
| 1720157225 | Town of Gorham | Ambulance | 347 Main St, Gorham, NH 03581 | 2006-11-07 |
| 1114288255 | Susan Martlock-j&s Care Enterprise | In Home Supportive Care | 2 1st St, Gorham, NH 03581-1007 | 2012-06-05 |
| 1003030552 | Jessica Cunningham | Specialist | 10 Madison Ave, Gorham, NH 03581-1107 | 2007-04-13 |
| 1568974996 | Kyle Matthew Boisselle | Specialist/Technologist | 18 Jewel St, Gorham, NH 03581-1211 | 2017-10-25 |
| 1811339823 | Alison Bernier | Occupational Therapist | 33 Glen Rd, Gorham, NH 03581-1333 | 2013-07-19 |
| 1821531229 | Jessica Stewart | Student in an Organized Health Care Education/Training Program | 80 Lancaster Rd, Gorham, NH 03581-1411 | 2016-12-02 |
| Find all providers in zip 03581 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730124710 | Karl A Miller | Family Medicine | 19 S Gorham Xing, Gorham, ME 04038-2690 | 2006-06-17 |
| 1790742898 | Michael K Duffy | Family Medicine | 19 South Gorham Crossing, Gorham, ME 04038-1912 | 2006-05-01 |
| 1760448211 | Jennifer Friedman | Family Medicine | 575 Main Street, Gorham, ME 04038 | 2006-04-25 |
| 1639532906 | Erin Evans Oakley | Family Medicine | 575 Main St, Gorham, ME 04038-2623 | 2016-04-03 |
| 1215375589 | Michelle Garcia | Family Medicine | 19 S Gorham Xing, Gorham, ME 04038-2690 | 2013-06-10 |
| 1073877791 | Tin Ha Ngoc | Family Medicine | 575 Main St, Gorham, ME 04038-2623 | 2012-06-27 |
| 1871813865 | Sarah E Gallo | Family Medicine | 575 Main St, Gorham, ME 04038 | 2010-06-02 |
| 1437487121 | Martin Francis Wesolowski | Family Medicine | 575 Main St, Gorham, ME 04038-1339 | 2009-11-18 |
| 1851558399 | Gorham Primary Care PC | Family Medicine | 130 Main St, Gorham, ME 04038-1319 | 2008-05-21 |
| 1295912665 | Andrew Stuart Nicholson | Family Medicine | 130 Main St, Gorham, ME 04038-1319 | 2008-01-28 |
| Find all providers in GORHAM | ||||
Please comment or provide details below to improve the information on SHERRILL TRACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.