Individual provider Active NPI

Nancy Joan Shepard, PT

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1497195192
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
902 Issued in OK
Practice address
15921 S Westminster Rd
Oklahoma City, OK 73165-7015
Phone
(405) 794-9556
NPI assigned
Jun 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 902 OK Primary

Addresses

Primary practice location

15921 S Westminster Rd
Oklahoma City, OK 73165-7015

Mailing address

15921 S Westminster Rd
Oklahoma City, OK 73165-7015
Phone (405) 794-9556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721001748 OK Practitioner - Physical Therapist in Private Practice 1850517277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
902OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skills for Living Inc CurrentSince Nov 8, 2018 Accepting new patients

Locations

330 W Gray St
Ste 100-2
Norman, OK 73069
Phone (405) 360-5552

1818 W Lindsey St
Ste D140
Norman, OK 73069
Phone (405) 329-4457

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1497195192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15921 S WESTMINSTER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731657015",
            "telephone_number": "405-794-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15921 S WESTMINSTER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731657015",
            "telephone_number": "405-794-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "NANCY",
        "middle_name": "JOAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.