Annette Ambito Shepherd, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95008959 Issued in CA

Practice address

340 4TH Ave Ste 11
Chula Vista, CA 91910

Phone

(619) 422-6158

NPI assigned

Jun 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pouya Afshar MD IncGroup PAC ID 1557656337, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Pouya Afshar MD Inc

  dba Integrated Healthcare Alliance Inc.

  • Specialist
  • San Diego, CA
  • NPI 1710336094
  Medicare reassignment Care Compare group NPD
• Molina Healthcare of California

  dba Molina Medical Centers

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1417441130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 4TH AVE STE 11",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-422-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 4TH AVE STE 11",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-422-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "ANNETTE",
        "middle_name": "AMBITO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-16",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008959",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95008959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF NURSING NURSE PRACTITIONER CERTIFICATE",
            "identifier": "95008959",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Nghien Sheehy, PHARM D.
• Jenneh Sheetz
• Karoline Sheffield, CMT, CMLDT
• Amanda Shelton
• Shemeka Harvey Rdhap Inc
• Lily Shepherd, APCC
• Marissa Agatha Sheppard, OTRL
• Lola Linda Sherman
• Kambiz Shetabi, M.D.
• Yili Shi, L.AC.

• Primary Care Nurse Practitioner in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.