Active NPI
Latonya Shepherd
- Registered Dietitian
- Winter Haven, FL
National Provider Identifier
1205613254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5447
- Practice address
- 200 Avenue F NE
Winter Haven, FL 33881-4131 - Phone
- (863) 297-1709
- NPI assigned
- Sep 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5447 | FL | Primary |
Addresses
Primary practice location
200 Avenue F NE
Winter Haven, FL 33881-4131
Mailing address
200 Avenue F NE
Winter Haven, FL 33881-4131
Phone (863) 297-1709
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 |
|---|---|---|---|
| 5447 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1205613254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 AVENUE F NE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814131",
"telephone_number": "863-297-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 AVENUE F NE",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814131",
"telephone_number": "863-297-1709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "LATONYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-13",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "5447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.