Kimberly Ann Shepard, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA001545 Issued in GA

Practice address

100 Somerby Dr
Alpharetta, GA 30009-8780

Phone

(770) 378-2328

Fax

(678) 987-7078

NPI assigned

Nov 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1295079812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 SERENADE CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300044958",
            "telephone_number": "770-378-2328",
            "fax_number": "678-987-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOMERBY DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098780",
            "telephone_number": "770-378-2328",
            "fax_number": "678-987-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA001545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Kenneth Shellington, M.D.
• Sheltering Arms Home Care LLC
• Haile Bryce Shelton
• Hannah Shelton
• Julia Shengaout, L.AC
• Tiffany Sheppard, RBT
• Mark Jason Sherling
• Nancy Shertok, M.S.W, L.C.S.W.
• Ritu Khanna Shetty, MD
• Areeba Shigri

• Physical Therapy Assistant in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.