Clarisa Shepard-Rhodes

Primary specialty

ContractorTaxonomy code 171W00000X

License

15-2108 Issued in OR

Practice address

251 NE Garden Valley Blvd
Suite 102
Roseburg, OR 97470-1498

Phone

(541) 440-0933

Fax

(541) 440-3707

NPI assigned

May 18, 2016

Last updated

May 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Advantage Home Care of Douglas County, Inc.

  • In Home Supportive Care Agency
  • Roseburg, OR
  • NPI 1912414855
  NPD (past) Authorized official

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1942657069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 NE GARDEN VALLEY BLVD",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701498",
            "telephone_number": "541-440-0933",
            "fax_number": "541-440-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 NE GARDEN VALLEY BLVD",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701498",
            "telephone_number": "541-440-0933",
            "fax_number": "541-440-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD-RHODES",
        "first_name": "CLARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OR",
            "license": "15-2108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149192",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Lee Sharp, DDS
• Laurence M. Sharp, DO
• Susan Sheely, MPT
• Nancy M, Sheiner, R.N., M.S.N.
• Samantha Marie Shelley, BS
• Leila Shepherd, LPCI
• Beverly Jean Sherwin, RPH
• Albert Shim, DDS
• Lauryn Shiplett, PHARM.D.
• Theresa Ann Shipley-Klein, P.T.

• Contractor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Contractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.