Ellen Shepherd, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164005986 Issued in IL

Practice address

10450 Algonquin Rd Ste 100a
Huntley, IL 60142-7064

Phone

(815) 334-5566

Fax

(847) 802-7259

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.63 of 100Reported as apm

Quality

88.47

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1831817618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 ALGONQUIN RD STE 100A",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427064",
            "telephone_number": "815-334-5566",
            "fax_number": "847-802-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 ALGONQUIN RD STE 100A",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427064",
            "telephone_number": "815-334-5566",
            "fax_number": "847-802-7259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3707 Doty Rd Ste G&h",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987530",
            "country_code": "US",
            "telephone_number": "815-334-5566",
            "fax_number": "815-759-4044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147994",
            "country_code": "US",
            "telephone_number": "815-334-5566",
            "fax_number": "815-759-4044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "ELLEN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ellen.shepherd@nm.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "4309 W Medical Center Dr Ste B205",
            "city": "McHenry",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600508417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Shaffer, RD
• Akash M Shah
• Mayuri A Shah, RPH
• Tejal Uday Shah, M.D.
• Bryan M Shanahan, PT, DPT
• Shina 007 Inc
• Shoptikal LLC
• Zachary J Sikora, PSY.D.
• Theresa Simandl, APRN, CNP
• Simpson Eye Associates LTD

• Registered Dietitian in Huntley, IL
• Providers in Huntley, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.