Individual provider Active NPI

John M Shepherd, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1699798280
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
K6319 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
NPI assigned
Jul 25, 2006
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X K6319 TX Primary
Pediatric Anesthesiology Physician 207LP3000X K6319 TX

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

PO Box 34717
San Antonio, TX 78265-4717
Phone (210) 615-1187

Other practice location 1

4242 Medical Dr Ste 3100
San Antonio, TX 78229-5642
Phone (210) 615-1187 ext. 555

Other identifiers 1

IdentifierTypeStateIssuer
1274813-03MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000120 TX Practitioner - Anesthesiology 1557548138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince Jul 15, 2023 Accepting new patients
Cleveland Regional Medical Center, LP Past Accepting new patients
Kenneth R Hart DO PA Past Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

Interoperability endpoints

  • Direct secure messaging: jshepherd50565@uhssa.direct-ci.com
  • Direct secure messaging: jshepherd64527@direct.utmsa.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1699798280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34717",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782654717",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4242 Medical Dr Ste 3100",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782295642",
            "country_code": "US",
            "telephone_number": "210-615-1187 x555",
            "fax_number": "210-614-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K6319",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "K6319",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1274813-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.