Active NPI
Christina Marie Shepard, MA, LAT, ATC
- Athletic Trainer
- Pueblo, CO
National Provider Identifier
1689229718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT.0001900
- Practice address
- 2200 Bonforte Blvd
Pueblo, CO 81001-4901 - Phone
- (719) 549-2234
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT.0001900 | CO | Primary |
Addresses
Primary practice location
2200 Bonforte Blvd
Pueblo, CO 81001-4901
Mailing address
2200 Bonforte Blvd
Pueblo, CO 81001-4901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT.0001900 | CO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1689229718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 BONFORTE BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810014901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BONFORTE BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810014901",
"telephone_number": "719-549-2234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPARD",
"first_name": "CHRISTINA",
"middle_name": "MARIE",
"credential": "MA, LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "AT.0001900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.