Active NPI
Taylor Brooke Shepherd, MD
- Pediatrics Physician
- Monroe, LA
National Provider Identifier
1124510052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 325897
- Practice address
- 2600 Tower Dr Ste 214
Monroe, LA 71201-5783 - Phone
- (318) 323-8824
- NPI assigned
- Jun 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL52544 | SC | |
| Pediatrics Physician | 208000000X | 325897 | LA | Primary |
Addresses
Primary practice location
2600 Tower Dr Ste 214
Monroe, LA 71201-5783
Mailing address
2600 Tower Dr Ste 214
Monroe, LA 71201-5783
Phone (318) 323-8824
Other practice location 1
169 Ashley Ave Rm 202
Charleston, SC 29425-8905
Phone (843) 792-8972
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181022003581 | SC | Order and Referring Only - Pediatric Medicine | 0143573014 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 325897 | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates, LLP | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Hospice and Palliative Medicine Physician
- Monroe, LA
- NPI 1144432204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1124510052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 TOWER DR STE 214",
"city": "MONROE",
"state": "LA",
"postal_code": "712015783",
"telephone_number": "318-323-8824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 TOWER DR STE 214",
"city": "MONROE",
"state": "LA",
"postal_code": "712015783",
"telephone_number": "318-323-8824"
}
],
"practiceLocations": [
{
"address_1": "169 Ashley Ave Rm 202",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294258905",
"country_code": "US",
"telephone_number": "843-792-8972",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEPHERD",
"first_name": "TAYLOR",
"middle_name": "BROOKE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-06",
"last_updated": "2021-08-10",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL52544",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "325897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.