Michael D. Shepherd M.D. Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G45994 Issued in CA

Legal business name

MICHAEL D. SHEPHERD M.D. INC.

Doing business as

FAMILY CARE PARTNERS

Practice address

15322 Lakeshore Dr
Ste. 201
Clearlake, CA 95422-9814

Phone

(707) 994-2920

Fax

(707) 994-2917

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Michael D. Shepherd, M.D.

Title

Physician

Phone

(707) 994-2920

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FAMILY CARE PARTNERS Doing business as

Locations

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1235328675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N 11TH AVE",
            "address_2": "STE. D",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303667",
            "telephone_number": "559-584-1881",
            "fax_number": "559-584-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15322 LAKESHORE DR",
            "address_2": "STE. 201",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229814",
            "telephone_number": "707-994-2920",
            "fax_number": "707-994-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. SHEPHERD M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "707-994-2920",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G45994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0082730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ43971Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY CARE PARTNERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael L. McKeown
• Jean M McNally, LCSW
• Medical Specialists Associates PC
• Katarina Maria Meyer
• Jeffrey W Meyers, PA-C
• Nyssa Rosina Midden
• Leshele Mielke
• Kayla Lynn Miller
• Sandra Janeane Miller
• Makayla Aillene Moglie

• Family Medicine Physician in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.