Individual provider Active NPI

Stephen Lee Shepherd, DO

  • Family Medicine Physician
  • Lakewood, CO
National Provider Identifier
1952697328
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0052985 Issued in CO
Practice address
8383 W Alameda Ave
Lakewood, CO 80226-3007
Phone
(303) 338-4545
NPI assigned
Jun 23, 2011
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0052985 CO Primary

Addresses

Primary practice location

8383 W Alameda Ave
Lakewood, CO 80226-3007

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 2

IdentifierTypeStateIssuer
08528578MedicaidCO
029153OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141204001609 CO Practitioner - Family Practice 2163744905 Reassigns benefits to 1 organization
I20190820003608 TN Practitioner - Family Practice 2163744905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

8301 W Alameda Ave
KP Lakewood Medical Offices/Urgent Care
Lakewood, CO 80226-3007
Phone (303) 338-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0052985COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DX Mso, PLLC CurrentSince Jun 9, 2019 Accepting new patients
Colorado Permanente Medical Group, P.C. CurrentSince Nov 9, 2020 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Dec 1, 2014 Accepting new patients
Portercare Adventist Health System CurrentSince Dec 1, 2014 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

950 E Harvard Ave
Ste 200
Denver, CO 80210
Phone (303) 649-3200

950 E Harvard Ave
Ste 660
Denver, CO 80210
Phone (303) 649-3200

8301 W Alameda Ave
Lakewood, CO 80226

8383 W Alameda Ave
Lakewood, CO 80226
Phone (303) 239-7253

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

1025 Peerless Xing NW
Cleveland, TN 37312
Phone 4234765990 ext. 104

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1952697328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 W ALAMEDA AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802263007",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "STEPHEN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0052985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08528578",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029153",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8383 W Alameda Ave",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802263007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.