Individual provider Active NPI

Sherry Labib Gergis, M.D.

  • Psychiatry Physician
  • Lake Mary, FL
National Provider Identifier
1720261472
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME116756 Issued in FL
Practice address
1301 S International Pkwy
Suite 2021
Lake Mary, FL 32746-1409
Phone
(330) 412-8187
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME116756 FL Primary

Addresses

Primary practice location

1301 S International Pkwy
Suite 2021
Lake Mary, FL 32746-1409

Mailing address

1301 S International Pkwy
Suite 2021
Lake Mary, FL 32746-1409
Phone (330) 412-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170503002128 FL Practitioner - Psychiatry 3173800091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northeastern Ohio University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2500 W Lake Mary Blvd
Suite 109
Lake Mary, FL 32746-3501
Phone (407) 324-0484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Psychiatric Health, LLC Psychiatry CurrentSince Feb 15, 2017 Accepting new patients

Locations

1301 S International Pkwy
Ste 2021
Lake Mary, FL 32746
Phone (407) 324-0424

2500 W Lake Mary Blvd
Ste 109
Lake Mary, FL 32746
Phone (407) 324-0484

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1720261472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S INTERNATIONAL PKWY",
            "address_2": "SUITE 2021",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461409",
            "telephone_number": "330-412-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S INTERNATIONAL PKWY",
            "address_2": "SUITE 2021",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461409",
            "telephone_number": "330-412-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGIS",
        "first_name": "SHERRY",
        "middle_name": "LABIB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME116756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.