Bradley Mark Shepherd, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2107 Issued in NM

Practice address

205 Boutz Road
Building 4 Suite 2
Las Cruces, NM 88005

Phone

(575) 915-1550

NPI assigned

Sep 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598915241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 WINDMILL DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118042",
            "telephone_number": "801-833-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BOUTZ ROAD",
            "address_2": "BUILDING 4 SUITE 2",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-915-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Windmill Dr",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880118042",
            "country_code": "US",
            "telephone_number": "801-833-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "BRADLEY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2022-07-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14070",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "71183171202",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina Ariana Sheets-Ochoa
• Lanova B Sheets, SLP
• Shelly R Noe, DNP, Pmhnp-BC
• Hallie Janee Shelton, MOTR/L
• Bryant Mario Shepard
• Reed Sheridan, PHARM.D.
• Judith Myers Sherman, MD
• Keenon Sherrell, LMSW
• Claire Ashburn Shervanick, MD
• San Curtis Shields, CNP

• Chiropractor in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.