Jonathan Joel Shepherd, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D0070538 Issued in MD

Practice address

6707 Whitestone Rd
Suite 106
Woodlawn, MD 21207-4106

Phone

(410) 265-8737

Fax

(410) 265-1258

NPI assigned

Jul 25, 2007

Last updated

Feb 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Premier Behavioral Health Services, P.C.

  • Clinical Psychologist
  • Bensenville, IL
  • NPI 1811168198
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1902096050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BRETON HILL RD",
            "address_2": "APT. #3B",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082716",
            "telephone_number": "312-391-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 WHITESTONE RD",
            "address_2": "SUITE 106",
            "city": "WOODLAWN",
            "state": "MD",
            "postal_code": "212074106",
            "telephone_number": "410-265-8737",
            "fax_number": "410-265-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JONATHAN",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0070538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Therese Royal, DDS
• Sage Health Maryland LLC
• Rebecca Lynn Sandham
• Bridget D Schilling
• Miriam Schwartz
• Angalene Sims
• Smile Street Dental
• Spectera
• Lisa Miller Strand, LCSW-C
• Towanda Street, LCPC

• Child & Adolescent Psychiatry Physician in Woodlawn, MD
• Providers in Woodlawn, MD by specialty
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.