Ivan Sherick, PH.D.

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

6301001107 Issued in MI

Practice address

220 Riverview Drive
Ann Arbor, MI 48104-1846

Phone

(734) 662-2211

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 1, 2016 through Feb 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184845877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RIVERVIEW DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041846",
            "telephone_number": "734-662-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RIVERVIEW DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041846",
            "telephone_number": "734-662-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERICK",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "MI",
            "license": "6301001107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE ID #",
            "identifier": "6301001107",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Sheppard-Cusumano, LMSW
• Pamela Joy Sheppard-Cusumano
• Christopher Isaac Sheppard, LPC
• John P Sherbeck, MD
• Haylee Sherby
• Amanda Sheridan
• Meghan Sheridan, RD, CDE
• William McKay Sherk, MD
• Annette Matruka Sherman, MSW
• Bryan Robert Sherman, MSPA-C

• All providers in Ann Arbor, MI
• Psychoanalyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.