Individual provider Active NPI

Jody Shepard

  • Counselor
  • Baton Rouge, LA
National Provider Identifier
1790204634
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1251 N Ardenwood Dr Apt 26
Baton Rouge, LA 70806-1935
Phone
(504) 799-5085
NPI assigned
Sep 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LA Primary

Addresses

Primary practice location

1251 N Ardenwood Dr Apt 26
Baton Rouge, LA 70806-1935

Mailing address

1251 N Ardenwood Dr Apt 26
Baton Rouge, LA 70806-1935
Phone (504) 799-5085

Other identifiers 1

IdentifierTypeStateIssuer
000000MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790204634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 N ARDENWOOD DR APT 26",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061935",
            "telephone_number": "504-799-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 N ARDENWOOD DR APT 26",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061935",
            "telephone_number": "504-799-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "JODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.