Sherri Marie Broadwater, MD
Individual provider Active NPI Psychiatry Physician · College Park, GA
NPI 1932394798 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1932394798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 67942 (GA)
- Practice address
- 3622 Main St
College Park, GA 30337-2721 - Phone
- (404) 458-0382
- NPI assigned
- Sep 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67942 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Health Science Center at Houston | Psychiatry | Past | Accepting new patients |
| The University of Texas Health Science Center at Houston | Past | Accepting new patients | |
| University of Texas Health Science Center at Houston | Past | Accepting new patients | |
| Healing for All LLC | Child & Adolescent Psychiatry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | M7633 | TX | |
| Psychiatry Physician | 2084P0800X | 67942 | GA | Yes |
Addresses
Primary practice location
3622 Main St
College Park, GA 30337-2721
Mailing address
3622 Main St
College Park, GA 30337-2721
Phone (404) 458-0382
Other practice location 1
445 Winn Way
Decatur, GA 30030-1707
Phone (404) 294-3835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 194238504 | Medicaid | TX |
Other names
- Dr. Sherri Marie Simpson
Other providers in College Park, GA
- Crystal Brantley
- Pamela Braxton
- Bridge the Journey, LLC
- Bridges of Success, Inc.
- Brighter Path & Associates, Inc.
- Antoine Brooks
- Darrell M Brooks
- Latisias E Brooks
- Brother 2 Brother Non Emergency Transportation Limo Service, LLC
- Adrian Michelle Brown
All providers in College Park, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.