Justin Shepherd, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07726 Issued in NC

Practice address

200 S Main St
Rich Square, NC 27869

Phone

(252) 539-2082

NPI assigned

Nov 29, 2017

Last updated

Nov 13, 2018By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med First Immediate Care and Family Practice PAGroup PAC ID 0446332720, 94 clinicians

Rural Health Group IncGroup PAC ID 9739090226, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.shepherd.1@1905.direct.athenahealth.com
• Direct secure messaging: justin.shepherd@rhgnc.eclinicaldirectplus.com

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.

• Rural Health Group, Inc.

  dba Rural Health Group at Jackson

  • Federally Qualified Health Center (FQHC)
  • Jackson, NC
  • NPI 1689626178
  Medicare reassignment Care Compare group NPD
• Med First Immediate Care & Family Practice, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1053503763
  Medicare reassignment Care Compare group
• Rural Health Group, Inc.

  dba Rural Health Group at Whitakers

  • Federally Qualified Health Center (FQHC)
  • Whitakers, NC
  • NPI 1013157171
  NPD
• Rural Health Group, Inc.

  dba Rural Health Group at Roanoke Rapids/Dental

  • Federally Qualified Health Center (FQHC)
  • Roanoke Rapids, NC
  • NPI 1669500997
  NPD
• Rural Health Group, Inc.

  dba Rural Health Group at Enfield

  • Federally Qualified Health Center (FQHC)
  • Enfield, NC
  • NPI 1952665929
  NPD
• Rural Health Group, Inc.

  dba Rural Health Group at Rich Square

  • Federally Qualified Health Center (FQHC)
  • Rich Square, NC
  • NPI 1962454447
  NPD

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

• Halifax Regional Medical Center Inc

  dba ECU Health North Hospital

  • General Acute Care Hospital
  • Roanoke Rapids, NC
  • NPI 1346273943
  Care Compare affiliation

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1205340247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "city": "RICH SQUARE",
            "state": "NC",
            "postal_code": "278699582",
            "telephone_number": "252-539-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "city": "RICH SQUARE",
            "state": "NC",
            "postal_code": "27869",
            "telephone_number": "252-539-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-29",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RV Assisted Living, LLC (Rich Square Villa)
• RV Assisted Living, LLC (Rich Square Manor)
• RV Nursing Home, LLC (Rich Square Health Care Center)
• RV Nursing Home, LLC (Rich Square Villa)
• RV Nursing Home, LLC (Rich Square Manor)
• Denise Young, LCASA

• Physician Assistant in Rich Square, NC
• Providers in Rich Square, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.