Tracy Sherman, PHD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5963 Issued in FL

Practice address

963 Holbrook Cir
Fort Walton Beach, FL 32547-6733

Phone

(850) 503-4071

Fax

(850) 999-7451

NPI assigned

Jan 3, 2006

Last updated

May 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1942288824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 HOLBROOK CIR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476733",
            "telephone_number": "850-503-4071",
            "fax_number": "850-999-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 HOLBROOK CIR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476733",
            "telephone_number": "850-503-4071",
            "fax_number": "850-999-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "PHD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5963",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010329600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010940100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Shelton, LMHC
• Sarah Shepherd
• Sheridan Childrens Healthcare Services Inc
• Breana Shae Sherman
• Nuite D Sherman
• Stacy R. Shidemantle, LMT
• Stephanie Lynn Shidemantle, PHARM.D.
• Shifah Counseling Services, PLLC
• Peter H Shih, M.D.
• Kristin Marie Shinnick, D.M.D

• Speech-Language Pathologist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.