Kenneth Stephen Shedd, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G62099 Issued in CA

Practice address

2221 Martin Luther King Jr Way
Oakland, CA 94612-1318

Phone

(510) 267-7901

Fax

(510) 267-7870

NPI assigned

Nov 29, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1932182466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 MARTIN LUTHER KING JR WAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121318",
            "telephone_number": "510-267-7901",
            "fax_number": "510-267-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 MARTIN LUTHER KING JR WAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121318",
            "telephone_number": "510-267-7901",
            "fax_number": "510-267-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "KENNETH",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G62099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhen She
• Holly Shea, PA
• Julian Michael Shea
• David L. Shearn, MD
• Heaven Simone Shears
• Shaun Sheehan
• Sheer Relaxation LLC
• Tammy L Sheffer-Woodward, MA, LLM, PSYD
• Yasmin Shehadeh
• Shazia Sheik

• Internal Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.