Scott B Shepard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001011979 Issued in NC

Practice address

105 Delta Park Dr Ste B
Shelby, NC 28150-3575

Phone

(704) 484-0464

Fax

(704) 482-0308

NPI assigned

May 4, 2006

Last updated

Feb 10, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Plastic Surgery and Dermatology PAGroup PAC ID 6800875188, 56 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.65 of 100Reported as group

Quality

91.92

Promoting interoperability

94

Improvement activities

40

Cost

78.58

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sshepard@piedmontderm.emadirect.md

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.

• Piedmont Plastic Surgery & Dermatology PA

  • Dermatology Physician
  • Gastonia, NC
  • NPI 1801832837
  Medicare reassignment Care Compare group
• Piedmont Plastic Surgery and Dermatology

  • Dermatology Physician
  • Shelby, NC
  • NPI 1316056104
  NPD (past)
• Coastal Radiology Associates PA

  • Diagnostic Radiology Physician
  • Fort Walton Beach, FL
  • NPI 1750524393
  NPD (past)
• Vascular Associates LLC

  • Specialist
  • Panama City, FL
  • NPI 1821129313
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1659339844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "704-671-1094",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DELTA PARK DR STE B",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503575",
            "telephone_number": "704-484-0464",
            "fax_number": "704-482-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "SCOTT",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011979",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA.9104640",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009450700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Radiological Associates, PA
• Shelby Rescue Squad Inc
• Shelby Surgical Associates, PA (Kings Mountain Surgical Assoicates, PA)
• Shelby Wellness & Therapy Center PLLC (Community Wellness Partners of NC, PLLC)
• Shelby Womens Clinic PA
• Tyra Shepeard, LCSWA
• Amy Marie Shepherd, DNP
• Sheila L Shepherd, PTA
• William Robert Shipley, MD
• Margaret Bralley Shires, GNP-C

• Physician Assistant in Shelby, NC
• Providers in Shelby, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.