Individual provider Active NPI

William Clinton McSherry, PH.D.

  • Health Service Psychologist
  • Durham, NC
National Provider Identifier
1932296613
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
03265 Issued in MD
Practice address
508 Fulton St
Ambulatory Care Service - 11C
Durham, NC 27705-3875
Phone
(919) 286-0411
Fax
(919) 416-8045
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 03265 MD Primary

Addresses

Primary practice location

508 Fulton St
Ambulatory Care Service - 11C
Durham, NC 27705-3875

Mailing address

508 Fulton St
Ambulatory Care Service - 11C
Durham, NC 27705-3875
Phone (919) 286-0411

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03265MDMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank W. Gibson, Jr. P.a. PastSince May 1, 1995 Accepting new patients

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1932296613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "address_2": "AMBULATORY CARE SERVICE - 11C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411",
            "fax_number": "919-416-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "address_2": "AMBULATORY CARE SERVICE - 11C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411",
            "fax_number": "919-416-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHERRY",
        "first_name": "WILLIAM",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MD",
            "license": "03265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.