Provider Demographics
NPI:1336509454
Name:JOHN SHERRY DPM PLC
Entity Type:Organization
Organization Name:JOHN SHERRY DPM PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:319-331-5194
Mailing Address - Street 1:1505 MALL DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-3111
Mailing Address - Country:US
Mailing Address - Phone:319-337-2135
Mailing Address - Fax:
Practice Address - Street 1:1505 MALL DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-3111
Practice Address - Country:US
Practice Address - Phone:319-337-2135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA00426213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3715OtherMIDLANDS CHOICE
IA0217356Medicaid
21735OtherBLUE CROSS BLUE SHIELD
5535730001Medicare NSC
21735OtherBLUE CROSS BLUE SHIELD
T01227Medicare UPIN