Individual provider Active NPI

Melissa Shepherd, FNP-BC

  • Primary Care Nurse Practitioner
  • Ft Carson, CO
National Provider Identifier
1760850531
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APN.0997944-NP Issued in CO
Practice address
1650 Cochrane Cir
Ft Carson, CO 80913-4613
Phone
(719) 524-4052
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209013130 IL
Primary Care Nurse Practitioner 363LP2300X APN.0997944-NP CO Primary

Addresses

Primary practice location

1650 Cochrane Cir
Ft Carson, CO 80913-4613

Mailing address

1650 Cochrane Cir Unit Meddac
Ft Carson, CO 80913-4604
Phone (719) 524-4052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005001708 IL Practitioner - Nurse Practitioner 3274841655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209013130ILMDFamily Nurse Practitioner
APN.0997944-NPCOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Physicians of Joliet SC CurrentSince Aug 29, 2018 Accepting new patients
Riverside Health System CurrentSince Aug 31, 2015 Accepting new patients
Riverside Health System CurrentSince Aug 31, 2015 Accepting new patients

Locations

2025 S Chicago St
Joliet, IL 60436
Phone (815) 726-2200

2025 S Chicago St
Ste 1
Joliet, IL 60436
Phone (815) 726-2200

1701 E Court St
Kankakee, IL 60901
Phone (815) 935-9394

611 S Division St
Peotone, IL 60468
Phone (708) 258-9058

121 Winchester Green Dr
Wilmington, IL 60481
Phone (815) 286-8487

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1760850531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-524-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-524-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013130",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "APN.0997944-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Carson, CO

Sources for this page

Verify at the official NPI Registry.