Active NPI
Tim Shepherd MD PA
- Family Medicine Physician
- Lewisville, TX
National Provider Identifier
1255655007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F4518
- Legal business name
- TIM SHEPHERD MD PA
- Practice address
- 500 N Valley Pkwy
Ste 101
Lewisville, TX 75067-3552 - Phone
- (972) 420-8777
- Fax
- (972) 219-1978
- NPI assigned
- Mar 23, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Tim S Shepherd, MD
- Title
- Owner
- Phone
- (972) 420-8777
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F4518 | TX | Primary |
Addresses
Primary practice location
500 N Valley Pkwy
Ste 101
Lewisville, TX 75067-3552
Mailing address
500 N Valley Pkwy
Ste 101
Lewisville, TX 75067-3552
Phone (972) 420-8777
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00Z699 | Other | TX | BLUE CROSS/BLUE SHIELD |
| 212009901 | Medicaid | TX | |
| B26392 | Other | TX | COMMERCIAL |
| DQ2129 | Other | TX | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
500 N Valley Pkwy
Ste 101
Lewisville, TX 75067
Phone (972) 420-8777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1285804800000",
"number": "1255655007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N VALLEY PKWY",
"address_2": "STE 101",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673552",
"telephone_number": "972-420-8777",
"fax_number": "972-219-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N VALLEY PKWY",
"address_2": "STE 101",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673552",
"telephone_number": "972-420-8777",
"fax_number": "972-219-1978"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIM SHEPHERD MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-23",
"last_updated": "2010-09-30",
"status": "A",
"authorized_official_last_name": "SHEPHERD",
"authorized_official_first_name": "TIM",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "972-420-8777",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "F4518",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "00Z699",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212009901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "B26392",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DQ2129",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.