Active NPI
Jason P Sheppard, LMSW- CLINICAL
- Clinical Social Worker
- Shelby TWP, MI
National Provider Identifier
1659984326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801117437
- Practice address
- 50258 Van Dyke Ave Ste a
Shelby TWP, MI 48317-1374 - Phone
- (585) 884-4714
- NPI assigned
- Aug 24, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801117437 | MI | Primary |
Addresses
Primary practice location
50258 Van Dyke Ave Ste a
Shelby TWP, MI 48317-1374
Mailing address
50258 Van Dyke Ave Ste a
Shelby TWP, MI 48317-1374
Phone (586) 884-4714
Medicare participation
Medicare enrollment files- 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: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801117437 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1659984326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50258 VAN DYKE AVE STE A",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483171374",
"telephone_number": "586-884-4714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50258 VAN DYKE AVE STE A",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483171374",
"telephone_number": "585-884-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "JASON",
"middle_name": "P",
"credential": "LMSW- CLINICAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-24",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801117437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.