Shepherd Park Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD16145 Issued in DC

Legal business name

SHEPHERD PARK MEDICAL CENTER

Practice address

7733 Alaska Ave NW
Washington, DC 20012-1421

Phone

(202) 882-5300

Fax

(202) 882-3758

NPI assigned

Feb 24, 2016

Organization subpart

No

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

Authorized official

Name

Amira Razzak Badaway

Title

Office Manager

Phone

(202) 882-5300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1285094995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 ALASKA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121421",
            "telephone_number": "202-882-5300",
            "fax_number": "202-882-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 ALASKA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121421",
            "telephone_number": "202-882-5300",
            "fax_number": "202-882-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD PARK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "BADAWAY",
        "authorized_official_first_name": "AMIRA",
        "authorized_official_middle_name": "RAZZAK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "202-882-5300"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "DC",
            "license": "MD16145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024734400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camarie Elizabeth Shepard, MOT OTR/L
• Marc Shepard, M.D.
• Lauren Shephard
• Molly Shephard, CD(CHB), CLC
• Shepherd Park Children's Academy LLC
• Brenda Shepherd-Vernon, LICSW
• Beatriz Shepherd
• Charles Shepherd
• Keonna Renee Shepherd
• Kyra Shepherd

• Primary Care Clinic/Center in Washington, DC
• Providers in Washington, DC by specialty
• Primary Care Clinic/Center in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.