Individual provider Active NPI

Altonya Sheppard

  • Case Manager/Care Coordinator
  • Philadelphia, PA
National Provider Identifier
1275247264
Registry record updated Apr 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2219 S Hobson St
Philadelphia, PA 19142-1804
Phone
(267) 221-1324
NPI assigned
Jan 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Peer Specialist 175T00000X 13063 PA
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2219 S Hobson St
Philadelphia, PA 19142-1804

Mailing address

2219 S Hobson St
Philadelphia, PA 19142-1804
Phone (267) 221-1324

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

State licenses

LicenseStateTypeSpecialty
13063PAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682726400000",
    "number": "1275247264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 S HOBSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191421804",
            "telephone_number": "267-221-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 S HOBSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191421804",
            "telephone_number": "267-221-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "ALTONYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-04-29",
        "certification_date": "2023-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "PA",
            "license": "13063",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2023; 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.