Alice Lyn Shepard, PNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP130674 Issued in TX

Practice address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542

Phone

(850) 883-8550

NPI assigned

Jul 10, 2012

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Nueces Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Corpus Christi, TX
  • NPI 1215314364
  NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1629333208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "68123",
            "telephone_number": "402-294-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "32542",
            "telephone_number": "850-883-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "ALICE",
        "middle_name": "LYN",
        "credential": "PNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP130674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crescent Seibert
• Emily Sexton, DDS
• Blake Richard Shaffer, MD
• Kyra Y Shea, D.M.D.
• Brian Robert Sheakoski, PHARM. D.
• Amelia Lane Sheppard, MD
• Patrick Leonard Short, M.D.
• Trevor A Simones, AUD
• Echo Sims
• Nicola Sing, M.D.

• Pediatric Nurse Practitioner in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.