Kenneth Shepardson, PHD

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

9332 Bear Basin CT
Las Vegas, NV 89178-5707

Phone

(702) 574-1996

NPI assigned

Dec 20, 2022

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

Practice roles

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.

• Yellow Tree Behavioral Health, LLC

  • Mental Health Counselor
  • Phoenix, AZ
  • NPI 1366138125
  NPD

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1982316063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9332 BEAR BASIN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891785707",
            "telephone_number": "702-574-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 BEAR BASIN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891785707",
            "telephone_number": "702-574-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARDSON",
        "first_name": "KENNETH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Shepard, RN
• Michael S. Shepard, PSY.D.
• Robert David Shepard, PT, DPT
• Tauni Shepard
• Teresa Shepard, RN, CDCES
• Gloria Maynor Shephard-Owens
• Dierdre Shephard
• William Shephard
• Shepherd Care Home Corp (Shepherd Care Home)
• Shepherd Eye Center

• Behavior Technician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.