Active NPI
Erica Joy Sheppard
- Physical Therapy Assistant
- Meridian, ID
National Provider Identifier
1073019212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4620
- Practice address
- 3025 W Cherry LN Ste D
Meridian, ID 83642-8531 - Phone
- (208) 367-8970
- NPI assigned
- Apr 5, 2018
- Last updated
- Apr 5, 2018
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 4620 | ID | Primary |
Addresses
Primary practice location
3025 W Cherry LN Ste D
Meridian, ID 83642-8531
Mailing address
56 N Stanford St
Nampa, ID 83651-2356
Phone (208) 318-3895
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 |
|---|---|---|---|
| 4620 | ID | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1073019212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 N STANFORD ST",
"city": "NAMPA",
"state": "ID",
"postal_code": "836512356",
"telephone_number": "208-318-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3025 W CHERRY LN STE D",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836428531",
"telephone_number": "208-367-8970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "ERICA",
"middle_name": "JOY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ID",
"license": "4620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.