Samuel Joseph Shepherd, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2020034759 Issued in MO

Practice address

2 E Gregory Blvd Ste 200
Kansas City, MO 64114-1118

Phone

(816) 926-0222

Fax

(816) 926-0277

NPI assigned

Oct 23, 2020

Last updated

Oct 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Physical Therapy and Rehab Services IncGroup PAC ID 1850370453, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Northland Physical Therapy & Rehab Services, Inc

  • Physical Therapist
  • N Kansas City, MO
  • NPI 1740273218

  KS

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1568061208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E GREGORY BLVD STE 200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141118",
            "telephone_number": "816-926-0222",
            "fax_number": "816-926-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06564",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020034759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael A Shepard, CRNA
• Darren W. Shepherd, LCSW
• Dayanand David Shepherd, LPC
• Kimberly Shepherd
• Malinda L Shepherd, BSN
• Barbara J Sheppard, ANP
• Scott I. Sher, M.D.
• Borin Sheri, FNP
• Sheridan Healthcare of Missouri Inc
• Debbie Snow Sheridan, MA

• Physical Therapist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.