Jan F Sherbak, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P02400 Issued in TN

Practice address

3023 Broad St
Chattanooga, TN 37408-3075

Phone

(423) 752-5207

Fax

(423) 752-5299

NPI assigned

Jan 18, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Beyoutiful Skin and Laser Center

  • Family Nurse Practitioner
  • Chattanooga, TN
  • NPI 1952724213
  NPD (past)
• Healthforce Corporation

  • Family Medicine Physician
  • Hixson, TN
  • NPI 1205882529
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1801948849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 BROAD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374083075",
            "telephone_number": "423-752-5207",
            "fax_number": "423-752-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 BROAD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374083075",
            "telephone_number": "423-752-5207",
            "fax_number": "423-752-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERBAK",
        "first_name": "JAN",
        "middle_name": "F",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P02400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3164854",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "455336000",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael D Shepherd, M.D.
• Rebekah Ann Shepherd, PHARMD
• Caitlyn Sheppard, RD
• Jerome Arnold Sherard, MD
• Mattie Yulonda Sherard, NP-C
• Traci Sherbondy, PT
• Stephanie Sheridan, ANP, MSN, CDN
• Dakota Blake Sherlin
• Tiffani Sherlin
• Kay Sherman, FNP

• Psychologist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.