Active NPI
Kathleen Jean Shepard, NP
- Family Nurse Practitioner
- Fort Sill, OK
National Provider Identifier
1568062057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201645
- Practice address
- 4301 Wilson St
Fort Sill, OK 73503-4472 - Phone
- (580) 558-2500
- NPI assigned
- Oct 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201645 | OK | Primary |
Addresses
Primary practice location
4301 Wilson St
Fort Sill, OK 73503-4472
Mailing address
4301 Wilson St
Fort Sill, OK 73503-4472
Phone (580) 558-2500
Other names 1
- Kathleen Jean Conklin
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | chcwf.com | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1568062057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 WILSON ST",
"city": "FORT SILL",
"state": "OK",
"postal_code": "735034472",
"telephone_number": "580-558-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 WILSON ST",
"city": "FORT SILL",
"state": "OK",
"postal_code": "735034472",
"telephone_number": "580-558-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPARD",
"first_name": "KATHLEEN",
"middle_name": "JEAN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-26",
"last_updated": "2024-01-04",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "201645",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "chcwf.com",
"affiliation": "N",
"endpointDescription": "alternate",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "na",
"address_1": "11220 Kylnn Creek Rd",
"city": "Elgin",
"state": "OK",
"country_code": "US",
"postal_code": "735383838",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "CONKLIN",
"middle_name": "JEAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Sill, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.