Brent Shepherd, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

10421634-1205 Issued in UT

Practice address

391 S Chipeta Way Ste C
Salt Lake City, UT 84108-1294

Phone

(801) 581-4800

NPI assigned

Apr 4, 2016

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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Undefined Physician Type (Specify)Also: Preventive Medicine

Education

University of Utah School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bshepherd179559@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• Utah Healthcare Institute Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1376597344
  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1770946998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 S CHIPETA WAY STE C",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081294",
            "telephone_number": "801-581-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S CHIPETA WAY STE C",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081294",
            "telephone_number": "801-581-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "BRENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "UT",
            "license": "10421634-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Shepard, PHD, CPCI
• Emily Catherine Shepard
• Haley N. Shepard, MD
• Noah Shepard
• Erin Shepardson, PT
• Collin Kenneth Shepherd, DPT
• Jessie Lea Shepherd, LCMHC
• Kaitlin H Shepherd
• Kathryn Shepherd
• Maryjane Shepherd, MD

• Occupational Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Occupational Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.