Ronald G Shepherd, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

AO5839 Issued in IA

Practice address

700 Eagle Ridge Rd
Le Claire, IA 52753-9593

Phone

(563) 289-3242

Fax

(563) 289-4541

NPI assigned

Jun 10, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Shepherd Chiropractic PLLC

  • Sports Physician Chiropractor
  • Le Claire, IA
  • NPI 1104565571
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1912901463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 EAGLE RIDGE RD",
            "city": "LE CLAIRE",
            "state": "IA",
            "postal_code": "527539593",
            "telephone_number": "563-289-3242",
            "fax_number": "563-289-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 EAGLE RIDGE RD",
            "city": "LE CLAIRE",
            "state": "IA",
            "postal_code": "527539593",
            "telephone_number": "563-289-3242",
            "fax_number": "563-289-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "RONALD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IA",
            "license": "AO5839",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "AO5839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132407",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "50512",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverside Family Eye Center LLC
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• Kimberly Ann Shaw, PA-C
• Shepherd Chiropractic PLLC
• Charles A Smith, DO
• Michelle M Sprengelmeyer, MD
• Spring Park Oral and Maxillofacial Surgeons, P.C.
• Michael T. Stecher, D.D.S.
• Rachel Anne Thennes, OTR/L

• Sports Physician Chiropractor in Le Claire, IA
• Providers in Le Claire, IA by specialty
• Sports Physician Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.