Virginia A Shepherd-Tackett, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012790 Issued in KY

Practice address

92 Pickett LN
Prestonsburg, KY 41653-8569

Phone

(606) 874-0112

Fax

(606) 874-0115

NPI assigned

Dec 4, 2018

Last updated

Dec 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1588134324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 PICKETT LN",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416538569",
            "telephone_number": "606-874-0112",
            "fax_number": "606-874-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 PICKETT LN",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416538569",
            "telephone_number": "606-874-0112",
            "fax_number": "606-874-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD-TACKETT",
        "first_name": "VIRGINIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvonta Shaw
• Amanda Shelton
• Anna Shelton
• Christy Shemwell
• Laryn Shephard, LPCC
• Ashley Nicole Shepherd, LCSW
• Bobbi Shepherd
• Crystal Shepherd
• Elizabeth Shepherd
• Jenny Shepherd

• Family Nurse Practitioner in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.