Active NPI
Thomas Maurice Sheppard, PHARMD
- Pharmacist
- Fond Du Lac, WI
National Provider Identifier
1508499112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18580-40
- Practice address
- 192 N Main St
Fond Du Lac, WI 54935-3462 - Phone
- (920) 921-5264
- Fax
- (920) 921-2760
- NPI assigned
- Feb 21, 2020
- Last updated
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18580-40 | WI | Primary |
Addresses
Primary practice location
192 N Main St
Fond Du Lac, WI 54935-3462
Mailing address
192 N Main St
Fond Du Lac, WI 54935-3462
Phone (920) 921-5264
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18580-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
192 N Main St
Fond du Lac, WI 54935
Phone (920) 921-5264
Organizations & group practices 2
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": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1508499112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 N MAIN ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549353462",
"telephone_number": "920-921-5264",
"fax_number": "920-921-2760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 N MAIN ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549353462",
"telephone_number": "920-921-5264",
"fax_number": "920-921-2760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "THOMAS",
"middle_name": "MAURICE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-21",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18580-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.