Tiffany Sandra Sheperd, DNP, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8112 Issued in WI

Practice address

4600 W Schroeder Dr
Brown Deer, WI 53223-1469

Phone

(414) 865-2500

NPI assigned

Sep 8, 2017

Last updated

Jan 3, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Outreach Community Health Centers IncGroup PAC ID 1355247735, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Outreach Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1710032669
  Medicare reassignment Care Compare group NPD
• Outreach Community Health Centers, Inc.

  dba Outreach Community Health Ctr at Wellpoint Care Ntwk

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1558231563
  NPD

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1548788623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 SIX MILE RD",
            "city": "BELGIUM",
            "state": "WI",
            "postal_code": "530049747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 W SCHROEDER DR",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532231469",
            "telephone_number": "414-865-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPERD",
        "first_name": "TIFFANY",
        "middle_name": "SANDRA",
        "credential": "DNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "8112",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "192836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Seppanen
• Sereneaid LLC
• Rene F Settle-Robinson, DPM
• Callen Shaw
• Dawn K Shelton-Williams, LCSW
• Shorehaven Behavioral Health
• Shorehaven Behavioral Health Inc
• Sarah Siker, MA
• Michelle Ann Simmons
• Jeffrey Scott Simon, MD

• Psychiatric/Mental Health Nurse Practitioner in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.