NPIMap

Individual provider Active NPI

Lisa A Shepherd, M.D.

  • Family Medicine Physician
  • Storm Lake, IA
National Provider Identifier
1063499184
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35941 Issued in IA
Practice address
2015 W 5TH St
Storm Lake, IA 50588-3000
Phone
(712) 732-5030
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35941 IA Primary

Addresses

Primary practice location

2015 W 5TH St
Storm Lake, IA 50588-3000

Mailing address

24 N 9TH St
Fort Dodge, IA 50501-3905
Phone (515) 574-6890

Other identifiers 15

IdentifierTypeStateIssuer
00881OtherIABC/BS ER LOCATION
01644OtherIAWELLMARK BCBS CLINIC LOCA
1469452MedicaidIA
I14710OtherIACOVENTRY HEALTH CARE
0121965OtherIAUNITED HEALTH CARE
246974OtherIAMIDLANDS CHOICE
4878OtherIAAVERA HEALTH PLAN
0469452MedicaidIN
45838OtherIASIOUX VALLEY HEALTH PLAN
42603840551041OtherIAWPS TRICARE
01644OtherIAFIRST ADMINISTRATORS
426038405OtherIACIGNA
9233000OtherIADAKOTACARE
0121965OtherIAMEDICA
703361045139OtherIAPREFERRED ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050505000140 IA Practitioner - Family Practice 4385610302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians
Sports Rehab and Professional Therapy Associates IncGroup PAC ID 1658289608, 124 clinicians

Practice addresses (Care Compare)

1525 W 5TH St
Storm Lake, IA 50588-3027
Phone (712) 732-4030

315 W 5TH St
Storm Lake, IA 50588-1743
Phone (712) 732-7724

802 Kenyon Rd
Fort Dodge, IA 50501-5740

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35941IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Trinity Regional Medical Center CurrentSince May 1, 2018 Accepting new patients
Buena Vista Regional Medical Center Past Accepting new patients

Locations

24 N 9th St
Ste A
Fort Dodge, IA 50501

800 Kenyon Rd
Ste S
Fort Dodge, IA 50501
Phone (515) 573-4141

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

1010 15th St N
Humboldt, IA 50548
Phone (515) 332-2015

2015 W 5th St
Storm Lake, IA 50588
Phone (717) 732-6650

Interoperability endpoints

  • Direct secure messaging: lshepherd158560@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1063499184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N 9TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013905",
            "telephone_number": "515-574-6890",
            "fax_number": "515-574-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883000",
            "telephone_number": "712-732-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "35941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ER LOCATION",
            "identifier": "00881",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS CLINIC LOCA",
            "identifier": "01644",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469452",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH CARE",
            "identifier": "I14710",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0121965",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "246974",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVERA HEALTH PLAN",
            "identifier": "4878",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0469452",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "45838",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "42603840551041",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST ADMINISTRATORS",
            "identifier": "01644",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "426038405",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9233000",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0121965",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "703361045139",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

Verify at the official NPI Registry.