Caroline Sheppard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006350 Issued in IL

Practice address

515 N State St Ste 900
Chicago, IL 60654-9104

Phone

(312) 245-9965

Fax

(312) 245-9964

NPI assigned

Oct 30, 2017

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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicago Cosmetic Surgery and Dermatology SCGroup PAC ID 8325005150, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: csheppard@directaddress.net

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.

• Chicago Cosmetic Surgery and Dermatology SC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1407068000
  Medicare reassignment Care Compare group
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Arlington Heights, IL
  • NPI 1497792618
  NPD (past)

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1144732140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N STATE ST STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606549104",
            "telephone_number": "312-245-9965",
            "fax_number": "312-245-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N STATE ST STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606549104",
            "telephone_number": "312-245-9965",
            "fax_number": "312-245-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "CAROLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Anne Shepherd, MD
• Jerry Shepherd, MD
• Richard F Shepherd, LCSW
• Sha'Quari Shepherd
• Kara Shepp, MS, RD, LDN
• Christine Sheppard, LCPC
• Danielle Sheppard, LCPC
• Kelly Sheppard, APRN, CNP
• Kelly Saunders Sheppard, P.T.
• Monica Roseann Sheppard

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.