NPIMap

Individual provider Active NPI

Kathleen Jo Sheppard, RN, FNPC

  • Family Nurse Practitioner
  • Simpsonville, SC
National Provider Identifier
1831384619
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1718 Issued in SC
Practice address
727 SE Main St Ste 300
Simpsonville, SC 29681-3249
Phone
(864) 522-1170
NPI assigned
Sep 13, 2007
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1718 SC Primary

Addresses

Primary practice location

727 SE Main St Ste 300
Simpsonville, SC 29681-3249

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other practice location 1

703 N Fant St
Anderson, SC 29621-5705
Phone (864) 512-2828

Other practice location 2

323 Lebby St
Pelzer, SC 29669-1754
Phone (864) 497-6666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000451 SC Practitioner - Nurse Practitioner 9537328422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

727 SE Main St
Suite 300
Simpsonville, SC 29681-3249
Phone (864) 522-1170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1718SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 8, 2021 Accepting new patients
Anmed Health CurrentSince Jan 1, 2012 Accepting new patients
Prisma Health University Medical Group CurrentSince Feb 8, 2021 Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health CurrentSince Jan 1, 2012 Accepting new patients
Anmed Health PastSince Jan 1, 2012 Accepting new patients

Locations

1100 W Franklin St
Anderson, SC 29624
Phone (864) 224-0822

703 N Fant St
Anderson, SC 29621
Phone (864) 225-5059

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

323 Lebby St
Fl 3
Pelzer, SC 29669
Phone (864) 947-6666

727 SE Main St
Ste 300
Simpsonville, SC 29681
Phone (864) 522-1170

Interoperability endpoints

  • Direct secure messaging: ksheppard123328@direct.ghs.myhfn.org
  • Direct secure messaging: ksheppard8415@direct.anmedhealth.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 48

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1831384619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SE MAIN ST STE 300",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813249",
            "telephone_number": "864-522-1170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 N Fant St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296215705",
            "country_code": "US",
            "telephone_number": "864-512-2828",
            "fax_number": "864-512-2265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 Lebby St",
            "address_purpose": "LOCATION",
            "city": "Pelzer",
            "state": "SC",
            "postal_code": "296691754",
            "country_code": "US",
            "telephone_number": "864-497-6666",
            "fax_number": "864-947-8621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "KATHLEEN",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "RN, FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.