BRADLEY DAVID SHEPHERD (NPI# 1649327594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649327594 |
| Entity Type | Individual |
| Full Name | BRADLEY DAVID SHEPHERD |
| Credential | MD |
| Practice Address |
1001 Summit Blvd Ste 200 Brookhaven GA 30319-6410 |
| Mailing Address |
1001 Athens GA 30601-3806 |
| Practice Telephone | 7709891668 |
| Practice Fax Number | 6783881759 |
| Mailing Telephone | 7065480008 |
| Mailing Fax Number | 7063699673 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 40842 | TN | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
066420 | GA | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
40842 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003110772F | 05 | |
| TN | 3001215 | 05 | |
| TN | BCBS | 4173855 | 01 |
| AETNA | 0009476173 | 01 | |
| KY | KENTUCKY MEDICAID | 7100033070 | 01 |
| RAILROAD MEDICARE | P00646975 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598915241 | Bradley Mark Shepherd | Chiropractor | 205 Boutz Road, Building 4 Suite 2, Las Cruces, NM 88005 | 2008-09-30 |
| Street Address |
1001 SUMMIT BLVD STE 200 |
| City | BROOKHAVEN |
| State | GA |
| Zip Code | 30319-6410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556717 | Ronika Cotton | Marriage & Family Therapist | 2002 Summit Boulevard, Suite 300, Atlanta, GA 30319 | 2020-04-14 |
| 1093369548 | Gordon Peace | Physical Therapist | 705 Town Blvd Ne S 550, Atlanta, GA 30319 | 2019-08-01 |
| 1124682281 | Tiffany Nicole Blamble | Physician Assistant | 2235 Briarwood Way Ne, Brookhaven, GA 30319 | 2019-04-24 |
| 1891286860 | Sandy Springs Center for Urologic Surgery LLC | Clinic/Center | 1450 S Johnson Ferry Rd Ste 100, Atlanta, GA 30319 | 2018-05-24 |
| 1578070355 | Aaron Knott | Physical Therapist | 4260 Peachtree Road, Atlanta, GA 30319 | 2018-01-03 |
| 1639683832 | Lauren Hamann | Physical Therapist | 3777 Peachtree Rd Ne Apt 933, Brookhaven, GA 30319 | 2017-11-27 |
| 1760993984 | Caroline M. Brackette | Counselor | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319 | 2017-10-15 |
| 1700328713 | Christina Head | Counselor | 1350 Dresden Drive, Atlanta, GA 30319 | 2016-11-08 |
| 1528432572 | Hillary Allyn Olivier | Occupational Therapist | 3747 Peachtree Rd, Atlanta, GA 30319 | 2015-11-13 |
| 1285025304 | Karl Weismantel | Physical Therapy Assistant | 1000 Lenox Park Blvd, Atlanta, GA 30319 | 2015-02-11 |
| Find all providers in zip 30319 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730741448 | Gastro Consultants of Atlanta PC | Internal Medicine | 5669 Peachtree Dunwoody Rd Ste 270, Atlanta, GA 30342-1786 | 2019-07-02 |
| 1023582798 | Digestive Care Consultants, LLC | Internal Medicine | 11315 Johns Creek Pkwy Ste 400, Johns Creek, GA 30097-1517 | 2019-01-16 |
| 1285122465 | Atlanta Premier Gi Endoscopy, LLC | Internal Medicine | 3400 Mcclure Bridge Rd Ste B201, Duluth, GA 30096-8705 | 2018-04-24 |
| 1346762838 | Precision Medical Center PC | Internal Medicine | 4646 N Shallowford Rd Ste 555, Atlanta, GA 30338-6308 | 2017-07-17 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1922407162 | Umg Gastroenterology LLC | Internal Medicine | 820 Saint Sebastian Way Ste 2f, Augusta, GA 30901-2636 | 2014-08-13 |
| 1841618881 | Leah G Katta | Internal Medicine | 3400 Old Milton Pkwy Ste 380, Alpharetta, GA 30005-3707 | 2014-04-05 |
| 1306276324 | Candler Gastroenterology | Internal Medicine | 380b Cedar St, Metter, GA 30439-4042 | 2013-11-13 |
| 1215377247 | Deepanshu Jain | Internal Medicine | 8855 Hospital Dr Ste 101, Douglasville, GA 30134-2256 | 2013-07-05 |
| 1114260833 | Shahzad Ahmed | Internal Medicine | 1301 Sigman Rd Ne Ste 170, Conyers, GA 30012-3923 | 2013-04-01 |
| Find all providers with the same taxonomy | ||||
| City | BROOKHAVEN |
| Zip Code | 30319 |
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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.