Kimberly Ann Shepherd, LICSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26838 Issued in MN

Practice address

7580 160TH St W
Lakeville, MN 55044-8348

Phone

(952) 898-1133

Fax

(952) 435-6797

NPI assigned

Feb 1, 2020

Last updated

Feb 1, 2020By the provider in NPPES

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

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Life Development Resources PAGroup PAC ID 5890779847, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life Development Resources, PA

  • Community/Behavioral Health Agency
  • Lakeville, MN
  • NPI 1902953169

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580515200000",
    "number": "1346871944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WINTHROP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194674",
            "telephone_number": "612-281-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448348",
            "telephone_number": "952-898-1133",
            "fax_number": "952-435-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LICSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-02-01",
        "certification_date": "2020-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Andreas Seywerd, DC
• Jessica Shannon, DC
• Sharif Transportation Inc
• Leah Lynn Sheff Burr, M.T.
• Juweyriyo Osman Sheikh
• Cailin Marie Shurson, D.C.
• Aneesa Siddiqui, PA-C
• Janelle Sikich
• Silver Peak Medical Staffing LLC
• Silvercare LLC

• Clinical Social Worker in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.