Active NPI
Mary Katherine Shepherd, PHARMD
- Pharmacist
- Johnson City, TN
National Provider Identifier
1396129359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39444
- Practice address
- 2240 N Roan St
Johnson City, TN 37601-2521 - Phone
- (423) 283-4942
- NPI assigned
- Jul 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 39444 | TN | Primary |
Addresses
Primary practice location
2240 N Roan St
Johnson City, TN 37601-2521
Mailing address
405 Garmon Dr
Kingsport, TN 37663-2505
Phone (276) 608-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39444 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Johnson City, TN
- NPI 1093722001
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437177600000",
"number": "1396129359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 GARMON DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376632505",
"telephone_number": "276-608-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 N ROAN ST",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376012521",
"telephone_number": "423-283-4942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "MARY",
"middle_name": "KATHERINE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-18",
"last_updated": "2015-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "39444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.