Grace Elizabeth Sidberry, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 6164 Issued in FL

Practice address

300 S Pine Island Rd
Suite 227
Plantation, FL 33324-2673

Phone

(954) 382-4889

Fax

(954) 382-4884

NPI assigned

Jul 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of North Texas HSC, College of Osteopathic Med, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Building Momentum Inc.

  • Clinical Psychologist
  • Plantation, FL
  • NPI 1710075916
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1154335495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S PINE ISLAND RD",
            "address_2": "SUITE 227",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242673",
            "telephone_number": "954-382-4889",
            "fax_number": "954-382-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PINE ISLAND RD",
            "address_2": "SUITE 227",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242673",
            "telephone_number": "954-382-4889",
            "fax_number": "954-382-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDBERRY",
        "first_name": "GRACE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPHEALTH PROVIDER #",
            "identifier": "SIDBGRAC",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "65-0991291",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter J Shulman, MD
• Melissa Shunk
• Ankita Shvets, DDS
• Kevin C Siao, DMD
• Angela Theresa Siclari, APRN
• Srinidhi Siddi
• Signet Diagnostic Imaging Services LLC
• Sara Sikander, DDS
• Shira Silber, LCSW
• Stephanie A Silberman, PH.D.

• Clinical Psychologist in Plantation, FL
• Providers in Plantation, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.