Active NPI
Russell Mark Sherbondy, DC
- Chiropractor
- West Allis, WI
National Provider Identifier
1871629113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2391012
- Practice address
- 1370 S 74TH St
Ste 101
West Allis, WI 53214-3059 - Phone
- (414) 769-7900
- Fax
- (414) 769-7953
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2391012 | WI | Primary |
Addresses
Primary practice location
1370 S 74TH St
Ste 101
West Allis, WI 53214-3059
Mailing address
W220S2041 Springdale Road
Waukesha, WI 53186
Phone (414) 769-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2391012 | WI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476921600000",
"number": "1871629113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W220S2041 SPRINGDALE ROAD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "53186",
"telephone_number": "414-769-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 S 74TH ST",
"address_2": "STE 101",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532143059",
"telephone_number": "414-769-7900",
"fax_number": "414-769-7953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERBONDY",
"first_name": "RUSSELL",
"middle_name": "MARK",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2016-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "2391012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.