Individual provider Active NPI

James Andrew Shepherd, MSU U/S

  • Clinical Social Worker
  • Vinita, OK
National Provider Identifier
1114552825
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22011 Issued in OK
Practice address
405 E Excelsior Ave
Vinita, OK 74301-4226
Phone
(918) 256-6476
NPI assigned
Mar 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OK
Clinical Social Worker 1041C0700X 22011 OK Primary

Addresses

Primary practice location

405 E Excelsior Ave
Vinita, OK 74301-4226

Mailing address

405 E Excelsior Ave
Vinita, OK 74301-4226
Phone (918) 256-6476

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

LicenseStateTypeSpecialty
8032-POKMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1114552825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JAMES",
        "middle_name": "ANDREW",
        "credential": "MSU U/S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-03",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "22011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.