Scott Allen Shappard Sr., DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O-292 Issued in ID

Practice address

10255 W. Overland Rd
Boise, ID 83709-1430

Phone

(208) 302-5600

Fax

(208) 302-5655

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sshappard1564034@direct.trinity-health.org

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.

• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1649275587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 EAST GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-5600",
            "fax_number": "208-302-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10255 W. OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091430",
            "telephone_number": "208-302-5600",
            "fax_number": "208-302-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPPARD",
        "first_name": "SCOTT",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O292",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806344300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dori A Shaner, LPC
• Kimberli Shaner, MS CCC-SLP
• Heather Shannon
• Nadamayi Shanti, LPC
• Lawrence Milton Shapiro, LMSW
• Aryan Patrick Sharif, DO
• Joelle Sharkey, MS, CCC-SLP
• David Edward Sharp, MS, LPC
• Jill McKenzie Sharp, RN, BSN
• Maria Sharp

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.