Zachary Gordon Shepherd, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

125 Route 340
Sparkill, NY 10976-1041

Phone

(651) 564-2194

NPI assigned

Jun 5, 2017

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962931832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ROUTE 340",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761041",
            "telephone_number": "651-564-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ROUTE 340",
            "city": "SPARKILL",
            "state": "NY",
            "postal_code": "109761041",
            "telephone_number": "651-564-2194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Wabasha",
            "state": "MN",
            "postal_code": "559811776",
            "country_code": "US",
            "telephone_number": "651-564-2194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Wabasha",
            "state": "MN",
            "postal_code": "559811776",
            "country_code": "US",
            "telephone_number": "651-564-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "ZACHARY",
        "middle_name": "GORDON",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sparkill, NY
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.