Tracee Michelle Shepard, P.T.A.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

117109 Issued in MO

Practice address

3120 Independence St
Cape Girardeau, MO 63703-5043

Phone

(573) 651-8242

Fax

(573) 651-8246

NPI assigned

May 17, 2017

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": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1306373675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MELISSAS DR",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637558813",
            "telephone_number": "573-587-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035043",
            "telephone_number": "573-651-8242",
            "fax_number": "573-651-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "TRACEE",
        "middle_name": "MICHELLE",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "117109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan H Sheets, D.D.S.
• Ahmad Zaki Sheikh, M.D.
• Taylor Shell-Taylor, PTA
• Jennifer Shelton, LCSW
• Matthew Shepard
• Airiel Reanna Denise Sheron
• Robert Wayne Sherrill, PT, CHT
• Wynnette Lynnelle Sherrill, OTR L CHT
• Rachel Shewmake, O.D.
• Darnesh Shiloh

• Physical Medicine & Rehabilitation Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.