Kyle Shepperson, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036108702 Issued in IL

Practice address

6810 State Route 162
Suite 10
Maryville, IL 62062

Phone

(618) 288-2020

Fax

(618) 288-7983

NPI assigned

Dec 8, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Mayo Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Community Hospital of Staunton Hospital, Staunton, IL, CCN 141306
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score

74.76 of 100Reported as group

Quality

54.98

Promoting interoperability

85

Improvement activities

40

Cost

73.39

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Anderson Medical Group, LLC

  • General Practice Physician
  • Maryville, IL
  • NPI 1700807716

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Granite City Orthopedic Physicians Company LLC

  • Orthopaedic Surgery Physician
  • Glen Carbon, IL
  • NPI 1508810920
  NPD (past)
• Orthopedic & Sports Medicine Clinic, P.C.

  • Orthopaedic Surgery Physician
  • Alton, IL
  • NPI 1982637658
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Community Hospital of Staunton

  • Critical Access Hospital
  • Staunton, IL
  • NPI 1750308631
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1407831704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "SUITE 10",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-288-2020",
            "fax_number": "618-288-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPERSON",
        "first_name": "KYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036108702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108702",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Senior Homecare LLC
• Serenity Surgery
• Charles Miguel Serrano, CRNA
• Samir K Shah, M.D.
• Jessica Lynn Sheffer, MSN, APRN, FNP-BC
• Jodie Shipley, DNP
• Holly Harlow Shirley, N.P.
• McKenna Ivy Shofroth, RN
• Lauren Kathryn Sidwell, FNP-BC
• Mark Silvey, CRNA

• Orthopaedic Surgery Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.