Individual provider Active NPI

Sheronda Denise Drisdom, MSN, ARNP, AOCNP

  • Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1770929994
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9185762 Issued in FL
Practice address
3730 7TH Terrace
Suite 101
Vero Beach, FL 32960-6556
Phone
(772) 581-0528
Fax
(772) 581-0535
NPI assigned
May 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 9185762 FL Primary

Addresses

Primary practice location

3730 7TH Terrace
Suite 101
Vero Beach, FL 32960-6556

Mailing address

4371 Veronica S Shoemaker Blvd
Attn: Credentialing Dept
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
017341700MedicaidFL

Other names 1

  • Sheronda Denise Brown Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150601002534 FL Practitioner - Nurse Practitioner 9335460435 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

3555 10TH CT
Suite 200B
Vero Beach, FL 32960-5013
Phone (772) 226-4810

Hospital & facility affiliations

  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9185762FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Apr 18, 2016 Accepting new patients
Indian River Health Services Inc CurrentSince Feb 13, 2019 Accepting new patients
Treasure Coast Palliative Care, LLC CurrentSince Jan 25, 2015 Accepting new patients
Indian River Health Services Inc CurrentSince Feb 13, 2019 Accepting new patients
Indian River Health Services Inc Past Accepting new patients
Indian River Memorial Hospital, Inc. Past Accepting new patients

Locations

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

5000 NW Dunn Rd
Fort Pierce, FL 34981
Phone (772) 403-4500

52 W Gore St
Orlando, FL 32806
Phone (407) 203-2700

1201 SE Indian St
Stuart, FL 34997
Phone (772) 403-4500

3730 7th Ter
Ste 101
Vero Beach, FL 32960
Phone (772) 567-2332

3555 10th Ct
Ste 200B
Vero Beach, FL 32960
Phone (772) 226-4810

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1770929994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "address_2": "ATTN: CREDENTIALING DEPT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 7TH TERRACE",
            "address_2": "SUITE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606556",
            "telephone_number": "772-581-0528",
            "fax_number": "772-581-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISDOM",
        "first_name": "SHERONDA",
        "middle_name": "DENISE",
        "credential": "MSN, ARNP, AOCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9185762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017341700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERONDA",
            "last_name": "BROWN",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.