Active NPI
Jennifer Sheppard, MSW, LICSW
- Clinical Social Worker
- Grand Rapids, MN
National Provider Identifier
1790168201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21941
- Practice address
- 413 SE 13TH St
Grand Rapids, MN 55744-0015 - Phone
- (218) 999-9908
- Fax
- (218) 999-9959
- NPI assigned
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21941 | MN | Primary |
Addresses
Primary practice location
413 SE 13TH St
Grand Rapids, MN 55744-0015
Mailing address
303 SE 1St St
Grand Rapids, MN 55744-3681
Phone (218) 360-2184
Other names 1
- Jennifer Halda
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
413 SE 13TH St
Grand Rapids, MN 55744-0015
Phone (218) 999-9908
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Homes, Inc | Current | Accepting new patients |
Locations
303 SE 1st St
Grand Rapids, MN 55744
Phone (218) 326-0349
413 SE 13th St
Grand Rapids, MN 55744
Phone (218) 327-3000
Organizations & group practices 1
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.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Grand Rapids, MN
- NPI 1790826550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1790168201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 SE 1ST ST",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557443681",
"telephone_number": "218-360-2184",
"fax_number": "218-999-7068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 SE 13TH ST",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557440015",
"telephone_number": "218-999-9908",
"fax_number": "218-999-9959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "JENNIFER",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-01",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "21941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "HALDA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grand Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.