Individual provider Active NPI

Jennifer Luella Sommer Sheppard, MSW, LCSW

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1487736930
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923407 Issued in CO
Practice address
11059 E Bethany Dr
Aurora, CO 80014-2622
Phone
(303) 617-2300
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16591 MN
Clinical Social Worker 1041C0700X CSW.09923407 CO Primary

Addresses

Primary practice location

11059 E Bethany Dr
Aurora, CO 80014-2622

Mailing address

11059 E Bethany Dr
Aurora, CO 80014-2622
Phone (303) 617-2300

Other identifiers 2

IdentifierTypeStateIssuer
056445000OtherMNMN HEALTH CARE PROGRAMS
HP70372OtherMNHEALTHPARTNERS

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

LicenseStateTypeSpecialty
CSW.09923407COMDClinical Social Worker
16591MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1487736930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11059 E BETHANY DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142622",
            "telephone_number": "303-617-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11059 E BETHANY DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142622",
            "telephone_number": "303-617-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMER SHEPPARD",
        "first_name": "JENNIFER",
        "middle_name": "LUELLA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16591",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN HEALTH CARE PROGRAMS",
            "identifier": "056445000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP70372",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.