Michelle R. Shepherd, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G154523 Issued in IA

Practice address

4600 3Rd St
Moline, IL 61265-6106

Phone

(309) 779-2031

NPI assigned

Jul 25, 2019

Last updated

Jul 25, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Robert Young Center for Community Mental HealthGroup PAC ID 4587600150, shared by 3 NPIs, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshepherd748797@direct.unitypoint.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.

• The Robert Young Center for Community Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Island, IL
  • NPI 1710276399
  Medicare reassignment NPD
• The Robert Young Center for Community Mental Health

  • Mental Health Counselor
  • Rock Island, IL
  • NPI 1972272516

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• The Robert Young Center for Community Mental Health

  dba Robert Young Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muscatine, IA
  • NPI 1063224426
  NPD

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1114571445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 CANAL SHORE DR SW",
            "city": "LE CLAIRE",
            "state": "IA",
            "postal_code": "527539564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 3RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656106",
            "telephone_number": "309-779-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MICHELLE",
        "middle_name": "R.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209019382",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G154523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Shattuck, RD
• Jennifer Shaw, ARNP
• Maille Sheerin
• Elizabeth R Shelly, PT
• Mark Jung-Ching Shen, M.D.
• Linda Kay Shields, CADC
• Justin Dwight Shoemaker, LCSW
• Kristin Marie Shumann, M.S.ED.
• Andrew Graham Sichling, LMSW
• Nicole C Sidock, O.D.

• Psychiatric/Mental Health Nurse Practitioner in Moline, IL
• Providers in Moline, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.