Individual provider Active NPI

Shannon Elizabeth Shepherd, CNM

  • Advanced Practice Midwife
  • Sidney, MT
National Provider Identifier
1114904976
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
253199 Issued in MT
Practice address
216 14TH Ave SW
Sidney, MT 59270-3519
Phone
(401) 488-2100
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN9341130 FL
Advanced Practice Midwife 367A00000X APRN11010478 FL
Advanced Practice Midwife 367A00000X 253199 MT Primary

Addresses

Primary practice location

216 14TH Ave SW
Sidney, MT 59270-3519

Mailing address

216 14TH Ave SW
Sidney, MT 59270-3519
Phone (406) 488-2100

Other identifiers 1

IdentifierTypeStateIssuer
765509669AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213003005 SC Practitioner - Certified Nurse Midwife (CNM) 7012938665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
1368AKMDPharmacist
28144SCMDAddiction Psychiatry Physician
APRN11010478FLMDAdvanced Practice Midwife
APRN9341130FLMDAdvanced Practice Midwife
253199MTMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Hartsville Medical Group LLC Advanced Practice Midwife CurrentSince Mar 1, 2024 Accepting new patients
All Womens Healthcare Inc Advanced Practice Midwife Past Accepting new patients

Locations

701 Medical Park Dr
Ste 304
Hartsville, SC 29550
Phone (843) 878-1004

701 Medical Park Dr
Ste 305B
Hartsville, SC 29550

700 Medical Park Dr
Hartsville, SC 29550
Phone (843) 383-3742

Networks

  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8689/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1114904976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "406-488-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "401-488-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN9341130",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11010478",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MT",
            "license": "253199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765509669A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, MT

Sources for this page

Verify at the official NPI Registry.