Active NPI
Clint Shepherd
- Foster Care Agency
- Marysvale, UT
National Provider Identifier
1831490317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- Practice address
- 8510 S Ten Mile Rd
Marysvale, UT 84750 - Phone
- (435) 201-9215
- Fax
- (435) 527-8883
- NPI assigned
- Nov 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Foster Care Agency | 253J00000X | Primary |
Addresses
Primary practice location
8510 S Ten Mile Rd
Marysvale, UT 84750
Mailing address
PO Box 133
Marysvale, UT 84750-0133
Phone (435) 201-9215
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piute Youth Development Center | Foster Care Agency | Past | Accepting new patients |
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.
-
- Foster Care Agency
- Marysvale, UT
- NPI 1558670612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1831490317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 133",
"city": "MARYSVALE",
"state": "UT",
"postal_code": "847500133",
"telephone_number": "435-201-9215",
"fax_number": "435-527-8883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8510 S TEN MILE RD",
"city": "MARYSVALE",
"state": "UT",
"postal_code": "84750",
"telephone_number": "435-201-9215",
"fax_number": "435-527-8883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "CLINT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.