Mary Elizabeth Shepherd, M.D.,PH.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

H6599 Issued in TX

Practice address

12545 Riata Vista Cir
Austin, TX 78727-6524

Phone

(512) 526-1776

Fax

(512) 298-1277

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.shepherd@49420620398596.direct.elationemr.com

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.

• Crossover Health Medical Group

  • Specialist
  • Austin, TX
  • NPI 1568250207
  NPD
• Nocturna of Waco LP

  • Sleep Disorder Diagnostic Clinic/Center
  • Waco, TX
  • NPI 1821250259
  NPD (past)
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Dermatology

  NPD (past)
• Ut Physicians

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1225110984
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1144210352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171179",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787170041",
            "telephone_number": "512-526-1776",
            "fax_number": "512-298-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 RIATA VISTA CIR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787276524",
            "telephone_number": "512-526-1776",
            "fax_number": "512-298-1277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 Travis St",
            "address_2": "Suite 980",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301312",
            "country_code": "US",
            "telephone_number": "713-500-8333",
            "fax_number": "713-500-8323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.,PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "H6599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8B8802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105402503",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mary.Shepherd@49420620398596.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct messaging address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12545 Riata Vista Cir",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787276524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Shepherd
• Joseph Shepherd
• Kimberly Olivier Shepherd, MA CCC/SLP
• Lauren Christine Correa Shepherd
• Lyn Shepherd
• Rachel Shepherd, MD
• Shari Ladell Shepherd, LVN
• Maria C Shepler, MD
• Madeline Sheppard-Marvin
• Erin D Sheppard, LPC-A

• Dermatology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.

Verify at the official NPI Registry.