Individual provider Active NPI

Patricia Shepard, LICSW

  • Clinical Social Worker
  • Fort Polk, LA
National Provider Identifier
1558774901
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
Bayne Jones Army Community Hospital
1585 Third St
Fort Polk, LA 71459
Phone
(337) 531-3783
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X WA Primary

Addresses

Primary practice location

Bayne Jones Army Community Hospital
1585 Third St
Fort Polk, LA 71459

Mailing address

9040 A Jackson Ave 2-2 Ebh BLDG R 1880
Joint Base Lewis McChord, WA 98431-0001

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNOtherTRICARE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260507000388 AL Practitioner - Clinical Social Worker 3274001375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remedy Behavioral Health LLCGroup PAC ID 3375958853, 46 clinicians

Practice addresses (Care Compare)

1609 Mockingbird CT
Suite B
Florence, AL 35630-7511
Phone (256) 320-7778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1558774901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 A JACKSON AVE 2-2 EBH BLDG R 1880",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYNE JONES ARMY COMMUNITY HOSPITAL",
            "address_2": "1585 THIRD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "71459",
            "telephone_number": "337-531-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "PATRICIA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "UNKNOWN",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

Verify at the official NPI Registry.