Individual provider Active NPI

John D Sheppard, MD

  • Emergency Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1578653010
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.27322 Issued in AL
Practice address
1251 McFarland Blvd NE
Tuscaloosa, AL 35406-2205
Phone
(205) 349-2323
Fax
(205) 349-1155
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.27322 AL Primary

Addresses

Primary practice location

1251 McFarland Blvd NE
Tuscaloosa, AL 35406-2205

Mailing address

1718 Veterans Memorial Pkwy
Suite a
Tuscaloosa, AL 35404-4791
Phone (205) 507-1100

Other identifiers 3

IdentifierTypeStateIssuer
1066796MedicaidLA
127467MedicaidAL
511-15303OtherALBLUE CROSS BLUE SHIELD

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070920000319 AL Practitioner - Emergency MedicinePractitioner - Family Practice 3870520646 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.27322ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pickens County Health Care Authority Current Accepting new patients
The DCH Healthcare Authority Current Accepting new patients
The DCH Health Care Authority CurrentSince Feb 28, 2024 Accepting new patients
West Alabama Palliative Care Service LLC Current Accepting new patients
Relias Emergency Medicine Specialists of Regional, LLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
DCH Healthcare Authority Current Accepting new patients
Lakeland Physician Practices LLC Past Accepting new patients

Locations

241 Robert K Wilson Dr
Carrollton, AL 35447
Phone (205) 367-2408

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

701 University Blvd E
Ste 211
Tuscaloosa, AL 35401
Phone (205) 333-4300

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

Interoperability endpoints

  • Direct secure messaging: john.sheppard.1@24945.direct.athenahealth.com

Organizations & group practices 7

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1578653010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 VETERANS MEMORIAL PKWY",
            "address_2": "SUITE A",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354044791",
            "telephone_number": "205-507-1100",
            "fax_number": "205-553-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 MCFARLAND BLVD NE",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062205",
            "telephone_number": "205-349-2323",
            "fax_number": "205-349-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.27322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1066796",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127467",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "511-15303",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.