Samantha Shepard

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

82348 Issued in KS

Practice address

1011 S Mount Carmel PL
Pittsburg, KS 66762-6604

Phone

(620) 670-6710

NPI assigned

Jun 12, 2022

Last updated

Sep 18, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center of Southeast Kansas IncGroup PAC ID 7911816392, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.shepard@chcsek.eclinicaldirectplus.com

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.

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1669474425
  Medicare reassignment Care Compare group NPD
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD
• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1427677723
  NPD
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1174525943
  NPD (past)
• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mound City, KS
  • NPI 1558830182
  NPD (past)
• Community Health Center of Southeast Kansas, Inc.

  dba Community Health Center of Southeast Kansas/Columbus Clinic

  • Federally Qualified Health Center (FQHC)
  • Columbus, KS
  • NPI 1972794402
  NPD (past)

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1962132134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S MOUNT CARMEL PL",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626604",
            "telephone_number": "620-670-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-115964",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "82348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbie Elizabeth Shaw, DMD
• Angela C Shaw, DO
• Porsche Sheehy
• Miah Melody Shelby, LMSW
• Terri Shelton
• Sharon Shepherd, LCMFT
• Robert Sheverbush, LCMFT
• Marina Shields
• Victoria A. Shirley, DO
• Amanda Lee Short, PTA

• Nurse Practitioner in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.
• 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.