Active NPI
Laine Sheppard, M.D.
- Adolescent Medicine (Internal Medicine) Physician
- Pensacola, FL
National Provider Identifier
1982730016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- 54144
- Practice address
- 250 Brent LN
Pensacola, FL 32503-2267 - Phone
- (850) 969-1936
- Fax
- (850) 969-1616
- NPI assigned
- Feb 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | 54144 | FL | Primary |
Addresses
Primary practice location
250 Brent LN
Pensacola, FL 32503-2267
Mailing address
250 Brent LN
Pensacola, FL 32503-2267
Phone (850) 969-1936
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 062848400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54144 | FL | MD | Adolescent Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1982730016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BRENT LN",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032267",
"telephone_number": "850-969-1936",
"fax_number": "850-969-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BRENT LN",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032267",
"telephone_number": "850-969-1936",
"fax_number": "850-969-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "LAINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-25",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "FL",
"license": "54144",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "062848400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.