David Shane Sherbondy, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

19749 Issued in SC

Practice address

112 Lovett Dr
Greenville, SC 29607-6510

Phone

(864) 987-9747

Fax

(864) 987-9770

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Excalibur Youth Services, LLC.

  • Psychiatric Residential Treatment Facility
  • Simpsonville, SC
  • NPI 1083852511
  NPD (past)
• S.C. Asset Management Inc.

  • Marriage & Family Therapist
  • Greenville, SC
  • NPI 1467674655
  NPD (past)
• Sherbondy'S LLC Psychiatric Services

  • Psychiatry Physician
  • Greenville, SC
  • NPI 1255353256
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1477572840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LOVETT DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076510",
            "telephone_number": "864-987-9747",
            "fax_number": "864-987-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LOVETT DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076510",
            "telephone_number": "864-987-9747",
            "fax_number": "864-987-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERBONDY",
        "first_name": "DAVID",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "19749",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "19749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Sheorn, D.O.
• Dorothy Shepard, FNP
• Maryann Boland Shepard, M.D.
• Codie A Sheppard, PTA
• John D Sherbert, MD
• Madison Taylor Sherbondy
• Morgan Alexis Sherbondy
• Sherbondy'S LLC Psychiatric Services
• Sherman Residential Care
• Cody Sherman, MD

• Child & Adolescent Psychiatry Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Child & Adolescent Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.