Active NPI
Jayne Tyson Shepherd
- Occupational Therapist
- Urbanna, VA
National Provider Identifier
1194226142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119000461
- Practice address
- 5372B Old Virginia St
Urbanna, VA 23175-2179 - Phone
- (804) 758-5250
- NPI assigned
- Feb 26, 2018
- Last updated
- Feb 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119000461 | VA | Primary |
Addresses
Primary practice location
5372B Old Virginia St
Urbanna, VA 23175-2179
Mailing address
911 Reisingers Rd
Warsaw, VA 22572-3109
Phone (804) 333-6319
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119000461 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1194226142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 REISINGERS RD",
"city": "WARSAW",
"state": "VA",
"postal_code": "225723109",
"telephone_number": "804-333-6319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5372B OLD VIRGINIA ST",
"city": "URBANNA",
"state": "VA",
"postal_code": "231752179",
"telephone_number": "804-758-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "JAYNE",
"middle_name": "TYSON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119000461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbanna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.