Jayson Daniel Shepherd, MS, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

088245 Issued in IA

Practice address

116 W South St
Warrensburg, MO 64093-2324

Phone

(660) 543-4111

Fax

(660) 543-8551

NPI assigned

Oct 12, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1376054742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W SOUTH ST",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640932324",
            "telephone_number": "660-543-4111",
            "fax_number": "660-543-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W SOUTH ST",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640932324",
            "telephone_number": "660-543-4111",
            "fax_number": "660-543-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JAYSON",
        "middle_name": "DANIEL",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "088245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serc Rehabilitation Partners, LLC
• George Ramey Sesser, PSY.D.
• Marcie Shea, M.D.
• Jacqueline Ann Sheehan, CRNA
• Bryan M Shepherd
• Sheridan Healthcare of Missouri, Inc.
• Cathy Jean Sherrer, FNP
• Alexis Erin Shields, LCSW
• Ibrahim A Shilbaya, PHARMD
• Kristie Lea Shockley, LMSW

• Athletic Trainer in Warrensburg, MO
• Providers in Warrensburg, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.