Kristin Sue Shepherd, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30054 Issued in AZ

Practice address

7757 W. Deer Valley Road Suite 275
Peoria, AZ 85382

Phone

(623) 878-2800

Fax

(623) 878-9150

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Great Destinations Pediatrics

  • Pediatrics Physician
  • Peoria, AZ
  • NPI 1235274051
  NPD (past) Authorized official
• Classic Care Pediatrics LLC

  • Pediatrics Physician
  • Peoria, AZ
  • NPI 1689915324
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1013016500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 W DEER VALLEY RD",
            "address_2": "SUITE 275",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822118",
            "telephone_number": "623-878-2800",
            "fax_number": "623-878-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7757 W. DEER VALLEY ROAD SUITE 275",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-878-2800",
            "fax_number": "623-878-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "KRISTIN",
        "middle_name": "SUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "30054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Shapiro
• Rahul Sharma, MD
• Quiarra Shaw- Gibson
• Thomas Shaw, PHARM.D.
• Monica Y Sheard, SLPA
• Zachary Daniel Sheridan
• Spencer Sherman
• Nisarg Sheth, MD
• Sandra Shi
• Mi-Kyong Kim Shields, NP

• Pediatrics Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.