Sheryle D. Gordon, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

25431 Issued in TX

Practice address

1409 N. Bishop Street
Suite 4-C
San Marcos, TX 78666-2675

Phone

(512) 496-5947

Fax

(866) 590-5947

NPI assigned

Sep 27, 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 1

Other names 1

• Dr. Sheryle G Beatty Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Spectrum Life Enhancement Associates, P.C.

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  NPD (past) Authorized official
• Deer Oaks Geriatric Services P C

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  • San Antonio, TX
  • NPI 1134169287
  NPD (past)
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1306937040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 STONEHAVEN",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786662365",
            "telephone_number": "512-496-5947",
            "fax_number": "866-590-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N. BISHOP STREET",
            "address_2": "SUITE 4-C",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786662675",
            "telephone_number": "512-496-5947",
            "fax_number": "866-590-5947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "453 N Business 35",
            "address_2": "Suite 421",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781307811",
            "country_code": "US",
            "telephone_number": "512-496-5947",
            "fax_number": "830-626-6207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SHERYLE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "25431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029552903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERYLE",
            "last_name": "BEATTY",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Breedlove Gonzales, PA-C
• Stephanie Gonzales
• Joshua Albert Gonzalez-Moreno, CF-SLP
• Maria Cristela Gonzalez, LCSW
• Roel Gonzalez, D.M.D.
• Kaylee Frances Gott
• Cathrin Gould, LCSW, LCDC,
• Michael J Grady, M.D.
• Graham a Hamilton
• Emily Granger, LAT, ATC

• Clinical Psychologist in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.