Jennifer R Shepherd, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4865 Issued in NC

Practice address

1630 Military Cutoff Rd
Suite 110
Wilmington, NC 28403-5719

Phone

(910) 798-2318

Fax

(910) 798-2319

NPI assigned

Jan 31, 2007

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Therapy for Women, Inc

  • Specialist
  • Wilmington, NC
  • NPI 1144406539

  Physical Therapist

  NPD Authorized official
• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1558598532
  NPD

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1174660054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MILITARY CUTOFF RD",
            "address_2": "SUITE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035719",
            "telephone_number": "910-798-2318",
            "fax_number": "910-798-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MILITARY CUTOFF RD",
            "address_2": "SUITE 110",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035719",
            "telephone_number": "910-798-2318",
            "fax_number": "910-798-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211054",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "017WJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "562246243001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPN",
            "identifier": "562099749",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A6058",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "232058",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John S Shelton, CPO
• Jenna Autumn Shemwell
• Max Shenin, DO
• Sarah Therese Shepard, DO
• Dustin R Shepherd
• April Naomi Sheppard
• George James Sheppard III, DDS
• Gene Stevenson Sherard Jr., B.S. PHARMACY
• Austin Nigel Sherman, MD
• Briana Jo Sherman, PT, DPT

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.