Individual provider Active NPI

Richard Sheppard, M.D.

  • Anesthesiology Physician
  • East Hartford, CT
National Provider Identifier
1700863461
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
030248 Issued in CT
Practice address
111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone
(860) 282-4137
Fax
(860) 282-0170
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 030248 CT Primary

Addresses

Primary practice location

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212

Mailing address

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone (860) 282-4137

Other identifiers 1

IdentifierTypeStateIssuer
001302489MedicaidCT

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: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030248CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uconn Health Center Anesthesiology Anesthesiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1700863461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "030248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001302489",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.