Jennifer Shepherd

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

20241048 Issued in MI

Practice address

36380 Garfield Rd Ste 4
Clinton Township, MI 48035-1162

Phone

(586) 825-3029

Fax

(586) 825-3028

NPI assigned

Jun 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Start LLC

  • Early Intervention Provider Agency
  • Clinton TWP, MI
  • NPI 1407392301
  NPD Authorized official
• Great Start Mihp LLC

  • Early Intervention Provider Agency
  • Clinton Township, MI
  • NPI 1669096947
  NPD Authorized official

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1972127256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36380 GARFIELD RD STE 4",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351162",
            "telephone_number": "586-825-3029",
            "fax_number": "586-825-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36380 GARFIELD RD STE 4",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351162",
            "telephone_number": "586-825-3029",
            "fax_number": "586-825-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "20241048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "coordinator@greatstartmihp.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "36380 Garfield Rd Ste 4",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480351162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelby Macomb Family Practice, P.C.
• Stephanie Shelton, BEHAVIOR TECHNICIAN
• Maria Shemit, FNP-BC
• Emmaneula Shepherd
• Erica Shepherd
• Jonathan Philip Sherman, PA-C
• Lauri Nicole Shields
• Shiloh Screenings LLC
• Chauntika Shinholster
• Lise A Shirtz, PH.D.

• Community Health Worker in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.