Individual provider Active NPI

Cynthia J Shepherd, PA-C

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1346349297
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00873 Issued in TX
Practice address
5414 S Broadway
Tyler, TX 75703-1335
Phone
(903) 581-1601
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00873 TX Primary

Addresses

Primary practice location

5414 S Broadway
Tyler, TX 75703-1335

Mailing address

PO Box 841656
Dallas, TX 75284-1656
Phone (903) 531-5000

Other practice location 1

2101 W Loop 281
Longview, TX 75604-2506
Phone (903) 315-4180

Other practice location 2

1339 S Broadway St
Sulphur Springs, TX 75482-4895
Phone (903) 951-1001

Other practice location 3

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2585

Other practice location 4

20208 State Highway 155 S
Flint, TX 75762-5600
Phone (903) 825-6222

Other identifiers 16

IdentifierTypeStateIssuer
75-0818167-015OtherTXTRICARE
298380104MedicaidTX
75-2616977-001OtherTXTRICARE
87N530OtherTXBCBS
P01762496OtherTXRAIL ROAD MEDICARE
75-0818167-044OtherTXTRICARE
75-2616977-002OtherTXTRICARE
75-2616977-028OtherTXTRICARE
P01761917OtherTXRAIL ROAD MEDICARE
75-2616977-129OtherTXTRICARE
298380106MedicaidTX
298380105MedicaidTX
75-0818167-022OtherTXTRICARE
75-0818167-048OtherTXTRICARE
298380107MedicaidTX
75-1976930-005OtherTXTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100804000192 TX Practitioner - Physician Assistant 6204969744 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

20208 State Hwy 155 S
Christus Trinity Clinic
Flint, TX 75762-5600
Phone (903) 825-6222

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00873TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Oct 31, 2016 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Oct 31, 2016 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 31, 2016 Accepting new patients

Locations

20208 State Highway 155 S
Flint, TX 75762
Phone (903) 825-6222

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

2101 W Loop 281
Longview, TX 75604
Phone (903) 315-4180

2010 Bill Owens Pkwy
Longview, TX 75604
Phone (903) 247-3400

1339 S Broadway St
Sulphur Springs, TX 75482
Phone (903) 951-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601

910 E Houston St
Ste 470
Tyler, TX 75702
Phone (903) 526-2644

Interoperability endpoints

  • Direct secure messaging: cshepherd108228@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1346349297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 S BROADWAY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031335",
            "telephone_number": "903-581-1601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 W Loop 281",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756042506",
            "country_code": "US",
            "telephone_number": "903-315-4180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1339 S Broadway St",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754824895",
            "country_code": "US",
            "telephone_number": "903-951-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20208 State Highway 155 S",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "TX",
            "postal_code": "757625600",
            "country_code": "US",
            "telephone_number": "903-825-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298380104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87N530",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01762496",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-044",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01761917",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-129",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298380106",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298380105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-048",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298380107",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-1976930-005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.