Kanna Shepherd, LOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

200683 Issued in LA

Practice address

4701 Montgomery Blvd NE
Albuquerque, NM 87109-1219

Phone

(505) 727-7800

NPI assigned

May 16, 2019

Last updated

May 16, 2019By the provider in NPPES

Sex

Female

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)

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

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  Occupational Therapist

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1376109181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 654",
            "city": "LAKE PROVIDENCE",
            "state": "LA",
            "postal_code": "712540654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091219",
            "telephone_number": "505-727-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "KANNA",
        "credential": "LOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "200683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Shenuski-Zetocha, SLP
• Angela Ellen Jane Shepard, LCSW
• Eddie Dupree Shepherd
• Erroll Shepherd Jr.
• Jennifer Mary Shepherd, D.C.
• Megan Shepherd, LPCC
• Ryan S Shepherd, D.M.D.
• Emmarie Sheppard
• Kristen Nicole Sheppard
• Shelbe Jordan Sheppard, LMSW

• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.