Individual provider Active NPI

James A. Shepard, DO

  • Internal Medicine Physician
  • Newark, DE
National Provider Identifier
1265844112
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C2-0012021 Issued in DE
Practice address
4755 Ogletown-Stanton Road
Suite 5A43
Newark, DE 19718-2200
Phone
(302) 623-0188
Fax
(302) 733-5640
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X UO4017 FL
Internal Medicine Physician 207R00000X C2-0012021 DE Primary

Addresses

Primary practice location

4755 Ogletown-Stanton Road
Suite 5A43
Newark, DE 19718-2200

Mailing address

200 Hygeia Drive
Suite 2300 CCHS Physician Contracting
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170720000381 DE Practitioner - Internal Medicine 2264652338 Reassigns benefits to 1 organization
I20211215002706 MD Practitioner - Internal Medicine 2264652338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C2-0012021DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County Internal Medicine CurrentSince Sep 10, 2021 Accepting new patients
Christiana Care Health Services Inc Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Union Hospital of Cecil County CurrentSince Sep 10, 2021 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 1, 2017 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188

4755 Ogletownstanton Rd
Newark, DE 19718
Phone (302) 733-6510

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 31

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.

View all 31

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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1265844112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE",
            "address_2": "SUITE 2300 CCHS PHYSICIAN CONTRACTING",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN-STANTON ROAD",
            "address_2": "SUITE 5A43",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "JAMES",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO4017",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C2-0012021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.