Nicole Shepard

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

041444374 Issued in IL

Practice address

15 W 3Rd St
Sterling, IL 61081-3510

Phone

(815) 632-5036

NPI assigned

Jun 13, 2023

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 names 1

• Nicole Suarez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1033893714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W 3RD ST",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610813510",
            "telephone_number": "815-632-5036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Miller Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "IL",
            "postal_code": "610811252",
            "country_code": "US",
            "telephone_number": "815-625-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "IL",
            "license": "041444374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SUAREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Starr Shamp, LPC
• William E Shaw Jr., PA-C
• Shaik Sheezan, DMD
• Verna Lee Sheffler
• Janda Kaye Sheimo
• Autumn Ruby Shomaker
• Samantha Shuman, RBT
• Shelley Siegmund
• Ashley Nicole Siepka, MSW
• Xitlali Crystal Sifuentes, DC

• Diabetes Educator Registered Nurse in Sterling, IL
• Providers in Sterling, IL by specialty
• Diabetes Educator Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.