Individual provider Active NPI

Ronald David Sherbert, D. O.

  • Family Medicine Physician
  • Grand Saline, TX
National Provider Identifier
1083677264
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E3450 Issued in TX
Practice address
709 N Waldrip St
Grand Saline, TX 75140-1555
Phone
(903) 962-3419
Fax
(903) 962-3635
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E3450 TX Primary

Addresses

Primary practice location

709 N Waldrip St
Grand Saline, TX 75140-1555

Mailing address

PO Box 553
709 N. Waldrip
Grand Saline, TX 75140-0553
Phone (903) 962-3419

Other identifiers 1

IdentifierTypeStateIssuer
099908802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1083677264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "address_2": "709 N. WALDRIP",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751400553",
            "telephone_number": "903-962-3419",
            "fax_number": "903-962-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N WALDRIP ST",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751401555",
            "telephone_number": "903-962-3419",
            "fax_number": "903-962-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERBERT",
        "first_name": "RONALD",
        "middle_name": "DAVID",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E3450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099908802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Saline, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.