NPIMap

Individual provider Active NPI

John David Shepherd, MD

  • Nephrology Physician
  • Pinehurst, NC
National Provider Identifier
1225031271
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
200200451 Issued in NC
Practice address
293 Olmsted Blvd
Ste 7
Pinehurst, NC 28374-9023
Phone
(910) 295-3344
Fax
(910) 295-3165
NPI assigned
May 23, 2005
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 200200451 NC Primary

Addresses

Primary practice location

293 Olmsted Blvd
Ste 7
Pinehurst, NC 28374-9023

Mailing address

293 Olmsted Blvd Ste 7
Pinehurst, NC 28374-9191
Phone (910) 295-3344

Other identifiers 1

IdentifierTypeStateIssuer
89131C9MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810001078 NC Practitioner - Nephrology 3173611175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Creighton University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinehurst Nephrology Associates PCGroup PAC ID 4880648864, 8 clinicians

Practice addresses (Care Compare)

293 Olmsted Blvd
Suite 7
Pinehurst, NC 28374-9191
Phone (910) 295-3344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
95.17
Improvement activities
40
Cost
82.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Nephrology Associates, PC Nephrology CurrentSince Jul 15, 2002 Accepting new patients

Locations

293 Olmsted Blvd
Ste 7
Pinehurst, NC 28374
Phone (910) 295-3344

Interoperability endpoints

  • Direct secure messaging: jshepherd16324@direct.acumenmd.com

Organizations & group practices 1

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.

Hospital & facility affiliations 9

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1225031271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 OLMSTED BLVD STE 7",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749191",
            "telephone_number": "910-295-3344",
            "fax_number": "910-295-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 OLMSTED BLVD",
            "address_2": "STE 7",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749023",
            "telephone_number": "910-295-3344",
            "fax_number": "910-295-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "200200451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89131C9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.