Laurie L Shepard, PT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

962 Issued in AZ

Practice address

6836 E Brown Rd
Ste 102
Mesa, AZ 85207-3756

Phone

(480) 924-5514

Fax

(480) 924-5518

NPI assigned

Jul 1, 2005

Reactivated

Jul 12, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
  • NPI 1285295089

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Arizona Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Peoria, AZ
  • NPI 1629698147
  Medicare reassignment NPD
• Spooner Chandler, PC

  • Physical Therapist
  • Chandler, AZ
  • NPI 1043225816
  Medicare reassignment
• Spooner Physical Therapy & Hand Rehab, PC

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
  • NPI 1205057320
  Medicare reassignment
• Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1609662709
  NPD

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1033116397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 W WARNER RD",
            "address_2": "SUITE A 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242713",
            "telephone_number": "480-821-2286",
            "fax_number": "480-821-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6836 E BROWN RD",
            "address_2": "STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073756",
            "telephone_number": "480-924-5514",
            "fax_number": "480-924-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "LAURIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2007-10-12",
        "deactivation_date": "2005-07-01",
        "reactivation_date": "2005-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054940",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Shelton, SLP
• Cynthia Elizabeth Shelton, WHNP
• Patricia Shelton, LPC11100
• Victor Shem
• Hani Shennib, MD
• Lisa Shepard, CRNFA
• Earlnsha L Shepherd
• Janet Shepherd
• Latisha Angela Shepherd
• Mitchell Shepherd, BCBA

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.