Active NPI
Ryan Stephen Sheppard, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Mobile, AL
National Provider Identifier
1396936589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 5437
- Practice address
- 5901 Grelot Rd
Mobile, AL 36609-3603 - Phone
- (251) 344-6191
- Fax
- (251) 344-6794
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | ALABAMA 5437 | TX | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 5437 | AL | Primary |
Addresses
Primary practice location
5901 Grelot Rd
Mobile, AL 36609-3603
Mailing address
5901 Grelot Rd
Mobile, AL 36609-3603
Phone (251) 344-6191
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1021853899 | Other | AL | MEDICARE PTAN |
| 3860118990 | Other | MYUTMB 3860118990 | |
| 05454 | Other | AL | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ALABAMA 5437 | TX | MD | Oral & Maxillofacial Surgery (D.M.D.) |
| 5437 | AL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1396936589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 GRELOT RD",
"city": "MOBILE",
"state": "AL",
"postal_code": "366093603",
"telephone_number": "251-344-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 GRELOT RD",
"city": "MOBILE",
"state": "AL",
"postal_code": "366093603",
"telephone_number": "251-344-6191",
"fax_number": "251-344-6794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "RYAN",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TX",
"license": "ALABAMA 5437",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AL",
"license": "5437",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "1021853899",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MYUTMB 3860118990",
"identifier": "3860118990",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "05454",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.