Sean Shepard
Individual provider Active NPI Physical Therapist · Alma, GA
NPI 1760027320 · NPPES record last updated Apr 9, 2020
Key facts
- NPI
- 1760027320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT011608 (GA)
- Practice address
- 139 Ga Hwy 32 Bypass
Alma, GA 31510 - Phone
- (912) 632-6321
- Fax
- (912) 632-6322
- NPI assigned
- Nov 7, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
139 Ga Hwy 32 Byp
Alma, GA 31510-2757
Phone (912) 632-6321
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200612002152 | GA | Practitioner - Physical Therapist in Private Practice | 2668894031 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011608 | GA | MD | Physical Therapist |
| OT005905 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shepard Therapy Center | Multi-Specialty | Current |
Accepting new patients |
Locations
139 GA Highway 32 Byp
Alma, GA 31510
Phone (912) 632-6321
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist |
225X00000X | OT005905 | GA | |
| Physical Therapist |
225100000X | PT011608 | GA | Yes |
Addresses
Primary practice location
139 Ga Hwy 32 Bypass
Alma, GA 31510
Mailing address
139 Ga Hwy 32 Bypass
Alma, GA 31510
Phone (912) 632-6321
Other providers in Alma, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.