Active NPI
Joshua Wayne Shepherd, PA-C
- Medical Physician Assistant
- Harrogate, TN
National Provider Identifier
1134405558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2060
- Practice address
- 165 Westmoreland St
Harrogate, TN 37752-8202 - Phone
- (423) 869-7193
- Fax
- (423) 869-7195
- NPI assigned
- Oct 31, 2011
- Last updated
- Oct 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2060 | TN | Primary |
Addresses
Primary practice location
165 Westmoreland St
Harrogate, TN 37752-8202
Mailing address
165 Westmoreland St
Harrogate, TN 37752-8202
Phone (423) 869-7193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2060 | TN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc. | Past | Accepting new patients |
Interoperability endpoints
- joshua.shepherd.1@19246.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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dba ARH Whitesburg Clinic
- Multi-Specialty Clinic/Center
- Whitesburg, KY
- NPI 1245446517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1134405558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 WESTMORELAND ST",
"city": "HARROGATE",
"state": "TN",
"postal_code": "377528202",
"telephone_number": "423-869-7193",
"fax_number": "423-869-7195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 WESTMORELAND ST",
"city": "HARROGATE",
"state": "TN",
"postal_code": "377528202",
"telephone_number": "423-869-7193",
"fax_number": "423-869-7195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "JOSHUA",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "2060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrogate, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.