Active NPI
Christopher W Sheppard, PHD
- Psychologist
- Orlando, FL
National Provider Identifier
1952855058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY11148
- Practice address
- 1317 Edgewater Dr # 4242
Orlando, FL 32804-6350 - Phone
- (719) 888-9165
- NPI assigned
- Aug 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY.0005601 | CO | |
| Psychologist | 103T00000X | PSYC.PY.70021929 | WA | |
| Psychologist | 103T00000X | LP03427 | KS | |
| Psychologist | 103T00000X | 1186 | NE | |
| Psychologist | 103T00000X | PSYPACT.9853 | FL | |
| Psychologist | 103T00000X | PY11148 | FL | Primary |
Addresses
Primary practice location
1317 Edgewater Dr # 4242
Orlando, FL 32804-6350
Mailing address
1317 Edgewater Dr # 4242
Orlando, FL 32804-6350
Phone (719) 888-9165
Other practice location 1
1155 SE City Beach St
# 838
Oak Harbor, WA 98277
Phone (360) 282-6585 ext. 4
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9853 | Other | PSYPACT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0005601 | CO | MD | Psychologist |
| PSYPACT.9853 | FL | MD | Psychologist |
| PY11148 | FL | MD | Psychologist |
| LP03427 | KS | MD | Psychologist |
| 1186 | NE | MD | Psychologist |
| PSYC.PY.70021929 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771459200000",
"number": "1952855058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1317 EDGEWATER DR # 4242",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328046350",
"telephone_number": "719-888-9165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 EDGEWATER DR # 4242",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328046350",
"telephone_number": "719-888-9165"
}
],
"practiceLocations": [
{
"address_1": "1155 SE City Beach St",
"address_2": "# 838",
"address_purpose": "LOCATION",
"city": "Oak Harbor",
"state": "WA",
"postal_code": "98277",
"country_code": "US",
"telephone_number": "360-282-6585 x4",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEPPARD",
"first_name": "CHRISTOPHER",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-08",
"last_updated": "2026-02-19",
"certification_date": "2026-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "PSY.0005601",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PSYC.PY.70021929",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KS",
"license": "LP03427",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "1186",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PSYPACT.9853",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY11148",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYPACT",
"identifier": "9853",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
- James Collier Shepard, LMHC
- Abigail Shepherd, MS., CF-SLP
- Sandra L Shepherd, P.A.
- Elaine Kay Shepherdson, LMHC
- Richard Andrew Shepler Jr., M.D.
- Glenda M Sheppard
- Monica Grace Sher, MD
- Amanda Lynn Sherfield, MSPT
- Sheridan Radiology Services of Central Florida, Inc.
- Sheridan Radiology Services of Pinellas, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.