Beverly Shepard, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F330120 Issued in NY

Practice address

1571 Washington St
Suite 201
Watertown, NY 13601-9304

Phone

(315) 782-1650

Fax

(315) 788-8547

NPI assigned

Dec 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• North Country Orthopaedic Group PC

  • Orthopaedic Surgery Physician
  • Watertown, NY
  • NPI 1568445344
  NPD
• Claxton-Hepburn Medical Center

  • Psychiatric Hospital Unit
  • Ogdensburg, NY
  • NPI 1346301389
  NPD (past)

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1831173079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-782-1650",
            "fax_number": "315-788-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "BEVERLY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F330120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02284366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey E Shambo, DNP-BC
• Mark Patrick Sharrow
• Heather Mary Shattuck, PTMS
• Brooke Laforty Shaw, CCC-SLP
• Jana Shaw, MD
• David Peter Shepard, M.A., CCC-SLP
• Deana Shepard
• Angel J Shepherd
• Megan M Shepherd, ATC
• Richard G Sherry, M.D.

• Nurse Practitioner in Watertown, NY
• Providers in Watertown, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.