Individual provider Active NPI

Elizabeth R Shepard, PA

  • Physician Assistant
  • Derry, NH
National Provider Identifier
1043518947
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0971 Issued in NH
Practice address
6 Tsienneto Rd Ste 100
Derry, NH 03038
Phone
(603) 537-1300
NPI assigned
Mar 2, 2011
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0971 NH Primary

Addresses

Primary practice location

6 Tsienneto Rd Ste 100
Derry, NH 03038

Mailing address

6 Buttrick Rd Ste 102
Londonderry, NH 03053-3417
Phone (603) 537-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131122000968 NH Practitioner - Physician Assistant 2668610254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone (603) 537-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0971NHMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: elizabethshepard@dmcnh.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1043518947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BUTTRICK RD STE 102",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533417",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD STE 100",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-537-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.