Active NPI
Denton Cade Shepherd
- Emergency Medicine Physician
- Kingman, AZ
National Provider Identifier
1699516468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- R4262
- Practice address
- 3269 N Stockton Hill Rd
Kingman, AZ 86409-3619 - Phone
- (928) 757-2101
- NPI assigned
- Jun 4, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | R4262 | AZ | Primary |
Addresses
Primary practice location
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Mailing address
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 757-2101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3514 Cedar Springs Rd
Dallas, TX 75219-4901
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4262 | AZ | MD | Emergency Medicine Physician |
Organizations & group practices 1
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bullhead City, AZ
- NPI 1518732023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1699516468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3269 N STOCKTON HILL RD",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093619",
"telephone_number": "928-757-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3269 N STOCKTON HILL RD",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093619",
"telephone_number": "928-757-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "DENTON",
"middle_name": "CADE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "R4262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.
- 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.