Individual provider Active NPI

Mendy M Shepard, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ottumwa, IA
National Provider Identifier
1205588191
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G166988 Issued in IA
Practice address
1527 Albia Rd
Ottumwa, IA 52501-3907
Phone
(641) 682-8772
Fax
(641) 682-1924
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G166988 IA Primary

Addresses

Primary practice location

1527 Albia Rd
Ottumwa, IA 52501-3907

Mailing address

1527 Albia Rd
Ottumwa, IA 52501-3907
Phone (641) 682-8772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220215001170 IA Practitioner - Nurse Practitioner 5496148421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keokuk County Health CenterGroup PAC ID 0244138774, 23 clinicians

Practice addresses (Care Compare)

1527 Albia Rd
Ottumwa, IA 52501-3907
Phone (641) 682-8772

23019 Hwy 149
Sigourney, IA 52591-8341
Phone (641) 622-2720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keokuk County Health Center CurrentSince Mar 14, 2025 Accepting new patients
Keokuk County Health Center CurrentSince Mar 14, 2025 Accepting new patients
Keokuk County Health Center Current Accepting new patients

Locations

1314 S Stuart St
Sigourney, IA 52591
Phone (641) 622-3840

1314 S Stuart St
Ste B
Sigourney, IA 52591
Phone (641) 622-1148

23019 Highway 149
Sigourney, IA 52591
Phone (641) 622-2720

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/keocohc-1efc0458

Organizations & group practices 4

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": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1205588191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 ALBIA RD",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013907",
            "telephone_number": "641-682-8772",
            "fax_number": "641-682-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 ALBIA RD",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013907",
            "telephone_number": "641-682-8772",
            "fax_number": "641-682-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "MENDY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G166988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

Verify at the official NPI Registry.