Individual provider Active NPI

Mark J Shepard, M.D.

  • Orthopaedic Surgery Physician
  • North Canton, OH
National Provider Identifier
1265420012
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35068710 Issued in OH
Practice address
7442 Frank Ave NW
North Canton, OH 44720-7022
Phone
(330) 305-0838
Fax
(330) 305-2514
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35068710 OH Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 34068710 OH

Addresses

Primary practice location

7442 Frank Ave NW
North Canton, OH 44720-7022

Mailing address

7442 Frank Ave NW
North Canton, OH 44720-7022
Phone (330) 455-5367

Other identifiers 2

IdentifierTypeStateIssuer
0156941MedicaidOH
H234290OtherOHMEDICARE ID-TYPE UNSPECIFIED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100121000439 OH Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8426190901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Washington University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthounited, Inc.Group PAC ID 9032197868, 89 clinicians

Practice addresses (Care Compare)

7442 Frank Ave NW
North Canton, OH 44720-7018
Phone (330) 305-0838

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.13 of 100Reported as group
Quality
74.6
Promoting interoperability
70
Improvement activities
40
Cost
84.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)39
Upper limb (arm) arthroscopy (minimally invasive joint repair)56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34068710OHMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthounited, Inc. Orthopaedic Surgery CurrentSince Jun 30, 1999 Accepting new patients
Orthounited, Inc. Orthopaedic Surgery CurrentSince Jun 30, 1999 Accepting new patients

Locations

6100 Whipple Ave NW
#180
Canton, OH 44720
Phone (330) 477-6251

7442 Frank Ave NW
North Canton, OH 44720
Phone (330) 305-0838

Interoperability endpoints

  • Direct secure messaging: mshepard@omni.medentdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1265420012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7442 FRANK AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207022",
            "telephone_number": "330-455-5367",
            "fax_number": "330-455-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7442 FRANK AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207022",
            "telephone_number": "330-305-0838",
            "fax_number": "330-305-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35068710",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "34068710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156941",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "H234290",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.