Krystal Shephard

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

7811 Issued in OK

Practice address

208 E. Broadway Ave.
Allen, OKLAHOMA 74825
UM

Phone

(580) 857-2125

Fax

(580) 857-2138

NPI assigned

Feb 9, 2016

Last updated

Feb 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Faith Home Care Services LLC

  • Home Health Agency
  • Tulsa, OK
  • NPI 1841222585
  NPD Authorized official
• Faith Home Care Services, LLC

  dba Image Home Care

  • Home Health Agency
  • Tulsa, OK
  • NPI 1801030291
  NPD
• MDR Health Group LLC

  dba OneHealth

  • Home Health Agency
  • McAlester, OK
  • NPI 1942287339
  NPD

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1912365685",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "208 E. BROADWAY AVE.",
            "city": "ALLEN",
            "state": "OKLAHOMA",
            "postal_code": "74825",
            "telephone_number": "580-857-2125",
            "fax_number": "580-857-2138"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "208 E. BROADWAY AVE.",
            "city": "ALLEN",
            "state": "OKLAHOMA",
            "postal_code": "74825",
            "telephone_number": "580-857-2125",
            "fax_number": "580-857-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHARD",
        "first_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7811",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "HC7821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568582468",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1942287339",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841222585",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.