Dexter Shepherd, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

174366 Issued in TN

Practice address

229 Bart Greene Dr
Johnson City, TN 37615-4612

Phone

(423) 946-0971

NPI assigned

Feb 1, 2016

Sex

Male

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dextershepherd@jcuc.medalliesdirect.net

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.

• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment
• Blue Ridge Medical Management Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1356472880
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1306204631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376158000",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 BART GREENE DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154612",
            "telephone_number": "423-946-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DEXTER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "174366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katessia Leann Shelton, COTA/L
• Mung-Hua Shen
• Ann Ramsey Shepard, RN
• Mary J Shephard, RD, RDN, LDN
• Alexandria Shepherd
• Mary Katherine Shepherd, PHARMD
• Matthew Sherban, D.M.D.
• Rebecca Sherfey, LPC-MHSP
• Steven John Sherfey, COUNSELOR
• Tara S Shields, MD

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.