Eugenia Marie Tice-Shepard, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

003818 Issued in NY

Practice address

160 E Main St
Port Jervis, NY 12771-2114

Phone

(845) 858-7110

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972727626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "UNIONVILLE",
            "state": "NY",
            "postal_code": "109880297",
            "telephone_number": "845-726-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712114",
            "telephone_number": "845-858-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE-SHEPARD",
        "first_name": "EUGENIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "003818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Sentinel of Port Jervis
• Avion J Thomas-Walsh, FNP
• Gincy Thomas, PT
• Thompson Town Dental PLLC (Port Jervis Smiles)
• Martha McPhail Thomson, NP
• Agnes Timberger, LISCENSED MASTER SOC
• Muhlise Dide Tosyali, D.M.D.
• Tri-State Emergency Physicians PLLC
• Tri-State Radiology, P.C.
• Lacey Anne Trimble, LCSW

• Physical Therapist in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.