Active NPI
Taylor Rudolph Sheppard, DO
- Student in an Organized Health Care Education/Training Program
- Lemoore, CA
National Provider Identifier
1255890174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 700 Avenger Ave
Lemoore, CA 93246-5000 - Phone
- (559) 998-4800
- NPI assigned
- Mar 19, 2019
- Last updated
- Jul 12, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary | |
| General Practice Physician | 208D00000X | 0102206339 | VA |
Addresses
Primary practice location
700 Avenger Ave
Lemoore, CA 93246-5000
Mailing address
6225 Humphreys Blvd
Memphis, TN 38120-2373
Other practice location 1
Naval Medical Center San Diego 38400 Bob Wilson Drive
San Diego, CA 92134-5000
Phone (901) 487-2842
Other practice location 2
6225 Humphreys Blvd
Memphis, TN 38120-2373
Phone (901) 227-9000
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206339 | VA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1255890174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6225 HUMPHREYS BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 AVENGER AVE",
"city": "LEMOORE",
"state": "CA",
"postal_code": "932465000",
"telephone_number": "559-998-4800"
}
],
"practiceLocations": [
{
"address_1": "Naval Medical Center San Diego 38400 Bob Wilson Drive",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921345000",
"country_code": "US",
"telephone_number": "901-487-2842",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6225 Humphreys Blvd",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381202373",
"country_code": "US",
"telephone_number": "901-227-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEPPARD",
"first_name": "TAYLOR",
"middle_name": "RUDOLPH",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-19",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0102206339",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lemoore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.