Heather Marie Sheppard, FNP-C
Individual provider Active NPI Nurse Practitioner · Hawkins, TX
NPI 1104209196 · NPPES record last updated Jan 25, 2016
Key facts
- NPI
- 1104209196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP128434 (TX)
- Practice address
- 5321 S FM 14
Hawkins, TX 75765-4839 - Phone
- (903) 769-2990
- NPI assigned
- Jul 8, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150915003128 | TX | Practitioner - Nurse Practitioner | 0749597292 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP128434 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Marsha Medical Group of Ca, P.C. | Past | Accepting new patients | |
| As Medical of New York PC | Past | Accepting new patients |
Locations
4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745
5321 S FM 14
Holly Lake Ranch, TX 75765
Phone (903) 769-2990
3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Interoperability endpoints
- hsheppard109804@direct.tmfhs.org
- heather.sheppard.1@22378.direct.athenahealth.com
- heather.sheppard.p1@direct.ppgt.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP128434 | TX | Yes |
Addresses
Primary practice location
5321 S FM 14
Hawkins, TX 75765-4839
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 349752101 | Medicaid | TX | |
| 75-2616977-023 | Other | TX | TRICARE |
| 75-2616977-066 | Other | TX | TRICARE |
| 8975NQ | Other | TX | BCBS |
Other providers in Hawkins, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.