Amy Ruth Shepard, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101016885 Issued in MI

Practice address

102 N Adelaide St
Fenton, MI 48430-2670

Phone

(810) 629-2245

Fax

(810) 629-6535

NPI assigned

Apr 4, 2007

Last updated

Oct 4, 2013By 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

Other names 1

• Miss Amy Ruth Gallagher Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.shepard.1@16555.direct.athenahealth.com
• Direct secure messaging: ashepard1151100@direct.hfhs.org

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.

• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Family Medicine Physician
  • Southfield, MI
  • NPI 1538123963
  NPD
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

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

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1093837718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N ADELAIDE ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302670",
            "telephone_number": "810-629-2245",
            "fax_number": "810-629-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N ADELAIDE ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302670",
            "telephone_number": "810-629-2245",
            "fax_number": "810-629-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "AMY",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GALLAGHER",
            "middle_name": "RUTH",
            "prefix": "MISS",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marc Kenneth Shaeffer
• My Le Shaw, M.D.
• Susan Marie Shaw, LPC
• Darcy Shay, FNP
• Madison Shegos, PA-C
• Thomas Showerman, DPT
• Avani Shukla, PHARMD
• Buford Harrison Shumaker, DDS
• Carl Albert Sigmund
• Silver Lake Counseling

• Family Medicine Physician in Fenton, MI
• Providers in Fenton, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.