Frederick Knight Sheppard, DC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

1883 Issued in WI

Practice address

2649 Bay Settlement Rd
Green Bay, WI 54311-7328

Phone

(906) 370-8335

NPI assigned

Nov 29, 2012

Last updated

Nov 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1760727937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 BAY SETTLEMENT ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "906-370-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 BAY SETTLEMENT RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543117328",
            "telephone_number": "906-370-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "FREDERICK",
        "middle_name": "KNIGHT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "1883",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301005616",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MI",
            "license": "2301005616",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WI",
            "license": "1883",
            "primary": true
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "WI",
            "license": "1883",
            "primary": false
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "MI",
            "license": "2301005616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E30003847",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Boehm Mattia MD,Adult Psychiatry, LLC
• Kyra Shelley, AUD
• Paul M Shen, MD
• Robin L Shepard, RN
• Kevin H Shepet, M.D.
• Jeffrey Lawrence Shere, MD
• Taylor Sheron, PA-C
• Pierce McCammon Sherrill, DO
• Tyler William Shimek
• Shivam 2 Holdings LLC (Chirology)

• Orthopedic Chiropractor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Orthopedic Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.