Active NPI
Roscoe Shepherd
- Physician Assistant
- Topeka, KS
National Provider Identifier
1093763997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-00895
- Practice address
- 2200 SW Gage Blvd
Topeka, KS 66622-0001 - Phone
- (785) 350-3111
- NPI assigned
- May 4, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-00895 | KS | Primary |
Addresses
Primary practice location
2200 SW Gage Blvd
Topeka, KS 66622-0001
Mailing address
2200 SW Gage Blvd
Topeka, KS 66622-0001
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 |
|---|---|---|---|
| 15-00895 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1093763997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 SW GAGE BLVD",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666220001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 SW GAGE BLVD",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666220001",
"telephone_number": "785-350-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "ROSCOE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-00895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.