John Dudley Shepherdson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Practice address

107 E Jefferson St
Morton, IL 61550-2001

Phone

(309) 266-9711

Fax

(309) 266-6322

NPI assigned

Aug 16, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Jefferson Street Clinic, SC

  • Clinic/Center
  • Morton, IL
  • NPI 1366637258
  NPD

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164535910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E JEFFERSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502001",
            "telephone_number": "309-266-9711",
            "fax_number": "309-266-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E JEFFERSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502001",
            "telephone_number": "309-266-9711",
            "fax_number": "309-266-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERDSON",
        "first_name": "JOHN",
        "middle_name": "DUDLEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "058746",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "227840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mickie Jean Schleef, D.C.
• Danielle Schmidgall, APN
• Jeffrey Daniel Schmidgall, D.C.
• Julie Kathryn Scott, MS LMT
• Anna Maria Sfeir, DDS
• Stephanie Shepherdson, P.T.
• G Gene Sidler, MD
• Signature Anesthesia LLC
• Michele Simmons, MS
• Gregory J Skibinski, LCPC

• Family Medicine Physician in Morton, IL
• Providers in Morton, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.