Diane Shepherd, REGISTERED NURSE

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

R-158091-4 Issued in MN

Practice address

115 Sixth St. NW
Suite E
Cass Lake, MN 56601-3061

Phone

(218) 335-8315

Fax

(218) 335-4578

NPI assigned

Mar 20, 2012

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1659646958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 6TH ST. NW",
            "address_2": "SUITE E",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SIXTH ST. NW",
            "address_2": "SUITE E",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566013061",
            "telephone_number": "218-335-8315",
            "fax_number": "218-335-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DIANE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "R-158091-4",
            "primary": true
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MN",
            "license": "R-158091-4",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R-158091-4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Robert Schaefer, PHYSICAL THERAPIST
• Ryan Schafer, PSYD
• Steven Schmitz, LPN
• Rita Marie Schuldt, RD, LD
• Bradley Scilley, RN
• Suzanne Sherry, P.T.
• Spencer E Shotley, LADC, CADC III
• Millicent A Simenson, LPN
• Catherine Spicer, LPN
• Celeste Stalberger

• Community Health Registered Nurse in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Community Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.