Individual provider Active NPI

Shelby Jean Sperr, PH.D

  • Clinical Psychologist
  • Augusta, GA
National Provider Identifier
1881615607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
614 Issued in GA
Practice address
3056 Walton Way Ext
Augusta, GA 30909-3469
Phone
(706) 736-2825
Fax
(706) 737-9706
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 614 GA Primary

Addresses

Primary practice location

3056 Walton Way Ext
Augusta, GA 30909-3469

Mailing address

3056 Walton Way Ext
Augusta, GA 30909-3469
Phone (706) 736-2825

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
614GAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881615607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093469",
            "telephone_number": "706-736-2825",
            "fax_number": "706-737-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093469",
            "telephone_number": "706-736-2825",
            "fax_number": "706-737-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERR",
        "first_name": "SHELBY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.