Sherry Dianne Dekeyser, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME162610 Issued in FL

Practice address

203 Fort Wade Rd Unit 260
Ponte Vedra, FL 32081-5159

Phone

(904) 902-4408

NPI assigned

May 25, 2006

Last updated

Apr 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ, FL2 enrollments

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.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serenity TMS Centers LLCGroup PAC ID 0840550596, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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

• Serenity TMS Centers LLC

  dba Serenity Mental Health Centers

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1710492095

  AZ, FL

  Medicare reassignment Care Compare group NPD
• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1518913540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N TRIUMPH BLVD STE 500",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840436475",
            "telephone_number": "801-821-2333",
            "fax_number": "801-901-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 FORT WADE RD UNIT 260",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815159",
            "telephone_number": "904-902-4408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 E Camelback Rd Ste 618",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850169040",
            "country_code": "US",
            "telephone_number": "480-626-2024",
            "fax_number": "480-210-0230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4545 E Chandler Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850487646",
            "country_code": "US",
            "telephone_number": "480-626-2024",
            "fax_number": "480-210-0230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 N Gilbert Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342394",
            "country_code": "US",
            "telephone_number": "480-626-2024",
            "fax_number": "480-210-0230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 N 95th Ln",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850374324",
            "country_code": "US",
            "telephone_number": "801-821-2781",
            "fax_number": "801-901-1194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20950 N Tatum Blvd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504258",
            "country_code": "US",
            "telephone_number": "480-626-2024",
            "fax_number": "480-210-0230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKEYSER",
        "first_name": "SHERRY",
        "middle_name": "DIANNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "10690",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "36746",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "50674",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME162610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0495341",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS BLUE",
            "identifier": "20589",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel M Calloway MD PA
• Jill A Darnell, RPH
• Jorge Enrique De la Rotta Soto, APRN
• Joshua Michael Dearth, PA-C
• Carla Marie Defuria, MBA, RDN, LDN
• Deliver PT, LLC
• Charles Michael Dellinger, PHARM.D.
• Debra Depto, PT
• Michael Derry
• Sharon Marie Desmarais, MD

• Psychiatry Physician in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.