Marietta Suzanne Shepherd, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04834 Issued in LA

Practice address

6723 Pines Rd Ste 112
Shreveport, LA 71129-2590

Phone

(318) 563-3944

NPI assigned

Oct 12, 2020

Last updated

Oct 12, 2020By the provider in NPPES

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

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therateam Outpatient Services, LLCGroup PAC ID 5597995233, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therateam Outpatient Services, LLC

  • Orthopedic Physical Therapist
  • Haughton, LA
  • NPI 1821333055
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1063010148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 PINES RD STE 112",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292590",
            "telephone_number": "318-562-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6723 PINES RD STE 112",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292590",
            "telephone_number": "318-563-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MARIETTA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "04834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti June Shelton, PLPC
• Shenells
• David Y. Sheng, MD
• Barbara Shepherd, RN
• Clifton W. Shepherd, MD
• Paula Y. Shepherd, M.ED.,LPC, LMFT
• Sonya Shepherd
• Temetha Shepherd
• Trenton B Shepherd, PT
• Shepherds Heart

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.