BRENT SHEPHERD (NPI# 1164687620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164687620 |
| Entity Type | Individual |
| Full Name | BRENT SHEPHERD |
| Credential | M.D. |
| Practice Address |
215 Chisholm Trl Jacksboro TX 76458-1403 |
| Mailing Address |
109 Valle Ct Azle TX 76020 |
| Practice Telephone | 9405675528 |
| Mailing Telephone | 8172871264 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2018-12-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | N6660 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LICENSE | N6660 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770946998 | Brent Shepherd | Preventive Medicine | 391 S Chipeta Way Ste C, Salt Lake City, UT 84108-1294 | 2016-04-04 |
| Street Address |
215 CHISHOLM TRL |
| City | JACKSBORO |
| State | TX |
| Zip Code | 76458-1403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777696 | Jack County Hospital District | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458 | 2005-08-17 |
| 1316418809 | Robert Cooper, M.d., Pa | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2018-12-10 |
| 1336651710 | Global Family Practice, Pllc | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2017-10-25 |
| 1841660560 | Becky Matlock | Counselor | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2015-10-07 |
| 1598146433 | Mackenzi Eberly | Nurse Practitioner | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2015-06-16 |
| 1780927707 | Robert Cooper | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2013-03-27 |
| 1710117833 | Debbie Lynn Young | Nurse Practitioner | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2009-07-23 |
| 1518109040 | Lara Marina Pierce | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2009-03-30 |
| 1790865293 | Jack County Hospital District | Medicare Defined Swing Bed Unit | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-17 |
| 1154419612 | Jack County Hospital District | Clinic/Center | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598274128 | Suzzan Bea Fleming | Nurse Practitioner | 1620 Fm 3344, Jacksboro, TX 76458 | 2017-09-27 |
| 1437157419 | Syed M Jamal | Internal Medicine | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2005-07-13 |
| 1144629197 | Mackenzie Prince | Registered Nurse | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2014-08-15 |
| 1093997785 | Babu Hosakote Subrahmanyam | Family Medicine | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2007-12-04 |
| 1336237890 | Jack County Hospital District | Ambulance | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2006-10-10 |
| 1104818723 | Faith Community Hospital Home Health | Home Health | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2005-08-19 |
| 1003965260 | Graham Regional Medical Center | General Acute Care Hospital | 611 N 4th St, Jacksboro, TX 76458-1113 | 2007-01-09 |
| 1417081688 | Graham Regional Medical Center | General Acute Care Hospital | 611 N 4th St, Jacksboro, TX 76458-1113 | 2007-03-16 |
| 1376043877 | Ashley Mae Chitwood | Licensed Vocational Nurse | 606 N 6th St, Jacksboro, TX 76458-1117 | 2018-02-20 |
| 1457657371 | Physician Services of Jacksboro Pa | Internal Medicine | 709 N 4th St, Jacksboro, TX 76458-1132 | 2011-02-10 |
| Find all providers in zip 76458 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427423078 | Jennie M Carter | Family Medicine | 3170 Appalachian Highway Ste 5, Jacksboro, TN 37757-3024 | 2015-12-08 |
| 1538104773 | Richard R Burdeaux Sr. | Family Medicine | 2545 Jacksboro Pike, Jacksboro, TN 37757-4847 | 2006-06-19 |
| 1790777696 | Jack County Hospital District | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458 | 2005-08-17 |
| 1316418809 | Robert Cooper, M.d., Pa | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2018-12-10 |
| 1336651710 | Global Family Practice, Pllc | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2017-10-25 |
| 1780927707 | Robert Cooper | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2013-03-27 |
| 1942598305 | Thomas Wayne Robbins | Family Medicine | 2545 Jacksboro Pike, Jacksboro, TN 37757 | 2011-07-19 |
| 1518109040 | Lara Marina Pierce | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2009-03-30 |
| 1093997785 | Babu Hosakote Subrahmanyam | Family Medicine | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2007-12-04 |
| 1376622639 | Summit Medical Group, Pllc | Family Medicine | 2545 Jacksboro Pike, Jacksboro, TN 37757-4847 | 2006-11-06 |
| Find all providers in JACKSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.