MS. SHARDE BRYAUN PETTIS M.A.
NPI 1578058608
Psychologist - Clinical Child & Adolescent in Cincinnati, OH

Q: What is Sharde Pettis's NPI number?

The NPI number for Sharde Pettis is 1578058608. It was assigned to this individual provider in the NPPES registry on July 1, 2018.

Q: What is Sharde Pettis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Sharde Pettis was last updated on April 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 01, 2018PECOS Enrolled

2825 BURNET AVE FL 4, CINCINNATI, OH 45219(513) 558-5857 Get Directions Write a Review

NPPES record last updated: April 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Ms. Sharde Bryaun Pettis M.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SHARDE BRYAUN PETTIS M.A. (NPI 1578058608) is an individual clinical child & adolescent provider in Cincinnati, Ohio and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578058608

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameMS. SHARDE BRYAUN PETTISCredential: M.A.

Location Address2825 BURNET AVE FL 4Cincinnati, OH 45219-2426

Mailing Address2825 Burnet Ave Fl 4Cincinnati, OH 45219-2426 · (513) 558-5857

Phone(513) 558-5857

Sole ProprietorNo

Enumeration DateJuly 1, 2018

Last NPPES UpdateApril 29, 2020

NPPES CertifiedApril 29, 2020

✔ NPI 1578058608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

2825 BURNET AVE FL 4, Cincinnati, OH 45219

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Sharde Bryaun Pettis M.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sharde Pettis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Children's Hospital

403 mi

Pediatrics

111 MICHIGAN AVE NW
Washington, DC 20010

Reassigned Medicare billing, District of Columbia enrollment
1,417 clinicians in this Medicare group

NPI 1780800128 (202) 476-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARIA PIOMBO ED. D, P.C.C.

Counselor (Mental Health)

2825 BURNET AVE FL 4
CINCINNATI, OH 45219

Hamilton County (513) 558-5890

MRS. CYNTHIA ANN RAUEN

Case Manager/Care Coordinator

2825 BURNET AVE FL 4
CINCINNATI, OH 45219

Hamilton County (513) 558-5857

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sharde Pettis's NPI number?

The NPI number for Sharde Pettis is 1578058608. It was assigned to this individual provider in the NPPES registry on July 1, 2018.

Where is Sharde Pettis located?

Sharde Pettis practices at 2825 Burnet Ave Fl 4, Cincinnati, OH 45219. The listed phone number is (513) 558-5857.

What is Sharde Pettis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Sharde Pettis enrolled in Medicare?

Yes. Sharde Pettis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sharde Pettis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sharde Pettis reassigns Medicare benefits to Children's Hospital (Washington, DC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sharde Pettis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sharde Pettis was last updated on April 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.