Active NPI
Maryann Christine Sheps, DC, PA-C,CPT
- Physician Assistant
- Augusta, GA
National Provider Identifier
1225106941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7169
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 724-6100
- NPI assigned
- Dec 1, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | A453639 | CA | |
| Physician Assistant | 363A00000X | 7169 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1499 Walton Way
Suite 1400
Augusta, GA 30901-2602
Phone (706) 724-6100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4411-8578 | Other | CA | CERTIFIED PHLEBOTOMY TECHNICIAN 1 LICENSE CERTIFICATION BY THE NHA |
| 7169 | Other | GA | GA PA LICENSE |
| PA18073 | Other | CA | PA LICENSE 18073 |
| A453639 | Other | CA | LICENSE |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7169 | GA | MD | Otolaryngology Physician |
| A453639 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421366400000",
"number": "1225106941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 WALTON WAY",
"address_2": "SUITE 1400",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012602",
"telephone_number": "706-724-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-724-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPS",
"first_name": "MARYANN",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "DC, PA-C,CPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2015-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "A453639",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "7169",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED PHLEBOTOMY TECHNICIAN 1 LICENSE CERTIFICATION BY THE NHA",
"identifier": "4411-8578",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA PA LICENSE",
"identifier": "7169",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA LICENSE 18073",
"identifier": "PA18073",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "A453639",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.