Peter Shepardson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

214719 Issued in MA

Practice address

1 Boston Medical Ctr PL
Suite 5108
Boston, MA 02118-2908

Phone

(617) 638-7062

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1760504559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "address_2": "SUITE 5108",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-638-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "address_2": "SUITE 5108",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-638-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARDSON",
        "first_name": "PETER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "214719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300881",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "0300030",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Youssef Shenouda
• Anuradha S Shenoy-Bhangle, MBBS
• Erica Seiguer Shenoy, MD, PHD
• Joanne Omalley Shepard, MD
• Ruth Gitchell Shepard, MS,RD,LDN
• Barbara A Shephard, MD
• Benjamin Shepherd, MS
• Christie Marie Shepherd, FNP
• Kimberly Shepherd, CNP
• Sarah Shepherd, NP

• Registered Nurse in Boston, MA
• Providers in Boston, MA by specialty
• Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.