Active NPI
Chase Douglas Shepard, PT, DPT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1033985122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-033338
- Practice address
- 775 E Willetta St
Phoenix, AZ 85006-2723 - Phone
- (480) 581-3900
- NPI assigned
- Nov 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | LPT-033338 | AZ | Primary |
Addresses
Primary practice location
775 E Willetta St
Phoenix, AZ 85006-2723
Mailing address
10236 N Tall Cotton Dr
Marana, AZ 85653-7919
Phone (520) 305-1816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPT-033338 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1033985122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10236 N TALL COTTON DR",
"city": "MARANA",
"state": "AZ",
"postal_code": "856537919",
"telephone_number": "520-305-1816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 E WILLETTA ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062723",
"telephone_number": "480-581-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPARD",
"first_name": "CHASE",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-29",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-033338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.