Provider Demographics
NPI:1558323907
Name:SHARPE, SHELDON THOMAS (BS,DC)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:THOMAS
Last Name:SHARPE
Suffix:
Gender:M
Credentials:BS,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 LUCILLE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7515
Mailing Address - Country:US
Mailing Address - Phone:859-625-4954
Mailing Address - Fax:
Practice Address - Street 1:2017 LUCILLE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7515
Practice Address - Country:US
Practice Address - Phone:859-625-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4912111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85003671Medicaid
KY85003671Medicaid
KY0961801Medicare PIN