Robert J. Sheppard, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301003402 Issued in MI

Practice address

5340 Holiday Ter
Kalamazoo, MI 49009-2196

Phone

(269) 372-4140

Fax

(269) 372-0390

NPI assigned

Nov 15, 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 MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Robert J. Sheppard PHD PLLC

  • Clinical Psychologist
  • Portage, MI
  • NPI 1083213631
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457333692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 CARLSBROOK LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244165",
            "telephone_number": "269-324-5027",
            "fax_number": "269-372-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140",
            "fax_number": "269-372-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "120811",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guy Clinton Shelley IV, MD
• Stacy Lee Shelly, RN
• Paula Marie Shelner, LMSW
• Dewayne Shelton
• Tyra Shepherd
• Frederick Sherburn, DO
• Sana Fatima Sheriff, MSM
• Anne Grace Sherman, BEHAVIOR TECHNICIAN
• Kyle Sherman
• Jacob Shermetaro, DO

• Clinical Psychologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.