Individual provider Active NPI

Mark M Shepherd, PA

  • Physician Assistant
  • Asheville, NC
National Provider Identifier
1154620227
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03466 Issued in NC
Practice address
1 Hospital Dr
Suite 4200
Asheville, NC 28801-4550
Phone
(828) 213-1111
NPI assigned
Mar 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-03466 NC
Physician Assistant 363A00000X 0010-03466 NC Primary

Addresses

Primary practice location

1 Hospital Dr
Suite 4200
Asheville, NC 28801-4550

Mailing address

PO Box 602373
Charlotte, NC 28260-2373
Phone (828) 213-1994

Other identifiers 2

IdentifierTypeStateIssuer
1154620227MedicaidNC
176H9OtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20120423000773 NC Practitioner - Physician Assistant 2961689815 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Health Community Multispecialty Providers LLCGroup PAC ID 9537468574, 601 clinicians

Practice addresses (Care Compare)

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

Hospital & facility affiliations

  • Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2112SCMDGeneral Practice Dentistry
TEMPORARYTXMDHematology & Oncology Physician
0010-03466NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Community Anesthesiology Specialists LLC CurrentSince Dec 1, 2018 Accepting new patients
Mission Health Community Multispecialty Providers, LLC Physician Assistant CurrentSince Dec 1, 2018 Accepting new patients
Mission Medical Associates, Inc CurrentSince Nov 2, 2015 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2014 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2014 Accepting new patients
Mission Community Anesthesiology Specialists LLC Past Accepting new patients
Spartanburg Emergency Physicians, LLC Past Accepting new patients

Locations

1 Hospital Dr
Ste 3400
Asheville, NC 28801
Phone (828) 252-3366

14 Medical Park Dr
Asheville, NC 28803
Phone (828) 213-4103

1 Hospital Dr
Asheville, NC 28801
Phone (828) 213-1994

1 Hospital Dr
Ste 4402
Asheville, NC 28801
Phone (828) 213-1990

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

21 Hospital Dr
Asheville, NC 28801
Phone (828) 213-0100

1 Hospital Dr
Ste 4200
Asheville, NC 28801
Phone (828) 213-1994

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1154620227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602373",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602373",
            "telephone_number": "828-213-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SUITE 4200",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014550",
            "telephone_number": "828-213-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-15",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-03466",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154620227",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "176H9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.