NPIMap

Individual provider Active NPI

Jennifer Eileen Shepard, MD

  • Pediatrics Physician
  • Oregon City, OR
National Provider Identifier
1144529306
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD165345 Issued in OR
Practice address
1510 Division St
Suite 280
Oregon City, OR 97045-1581
Phone
(503) 905-3400
NPI assigned
Mar 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD165345 OR Primary
Pediatric Hematology & Oncology Physician 2080P0207X MD165345 OR

Addresses

Primary practice location

1510 Division St
Suite 280
Oregon City, OR 97045-1581

Mailing address

1510 Division St
Suite 280
Oregon City, OR 97045-1581
Phone (503) 905-3400

Other names 1

  • Dr. Jennifer Eileen Atkin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD165345ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Falls Pediatric Group Pediatrics Past Accepting new patients
Willamette Falls Pediatric Group, PC Pediatrics Past Accepting new patients

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": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1144529306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST",
            "address_2": "SUITE 280",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451581",
            "telephone_number": "503-905-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST",
            "address_2": "SUITE 280",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451581",
            "telephone_number": "503-905-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "JENNIFER",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD165345",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "OR",
            "license": "MD165345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ATKIN",
            "middle_name": "EILEEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.