Dakota Shepherd, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2803 Issued in OK

Practice address

13801 N Western Ave Ste B
Edmond, OK 73013-1798

Phone

(405) 946-7300

NPI assigned

Jan 23, 2023

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

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.

• HPC Holdings LLC

  dba 360 Physical Therapy

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1396262234
  NPD

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1306552435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 PATCO SPUR AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997166",
            "telephone_number": "405-625-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 N WESTERN AVE STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131798",
            "telephone_number": "405-946-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DAKOTA",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Wayne Shelton, M.D.
• Kyle William Shelton
• Laci Shelton
• Shepard Chiropractic and Wellness P.L.L.C. (Shepard Chiropractic Clinic)
• Matthew Scott Shepard, D.C
• Jason Dale Shepherd
• Katherine Luthey Shepherd, DO
• Cynthia Ann Sherbon, LMFT LADC
• Sheridan Anesthesia Services of Oklahoma, Inc
• Kelli R Sheridan

• Physical Therapy Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.