MRS. LISA L SHEPHERD (NPI# 1922112978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922112978 |
| Entity Type | Individual |
| Full Name | MRS. LISA L SHEPHERD |
| Credential | CNP |
| Practice Address |
117 W Main St Camargo IL 61919-3312 |
| Practice Telephone | 2178322602 |
| Practice Fax Number | 2178328358 |
| Mailing Telephone | 2178322602 |
| Mailing Fax Number | 2178328358 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063499184 | Lisa A Shepherd | Family Medicine | 2015 W 5th St, Storm Lake, IA 50588-3000 | 2005-12-29 |
| 1467960450 | Lisa Shepherd | Physical Therapist | Womack Army Medical Center 2817 Reilly Road, Fort Bragg, NC 28310-0001 | 2018-01-12 |
| 1730619974 | Lisa Ann Shepherd | Occupational Therapist | 240 Branchview Dr Ne, Concord, NC 28025 | 2017-06-19 |
| Street Address |
117 W MAIN ST |
| City | CAMARGO |
| State | IL |
| Zip Code | 61919-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174639223 | Family Health Center of East Central Illinois, Inc. | Nurse Practitioner | 117 W Main St, Camargo, IL 61919-3312 | 2006-08-22 |
| 1689676033 | Daphne Louise Piercy | Nurse Practitioner | 117 W Main St, Camargo, IL 61919-3312 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700277829 | Samantha Hall | Student in an Organized Health Care Education/Training Program | Rr 1 Box 7720, Camargo, OK 73835-9728 | 2015-02-11 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174639223 | Family Health Center of East Central Illinois, Inc. | Nurse Practitioner | 117 W Main St, Camargo, IL 61919-3312 | 2006-08-22 |
| 1689676033 | Daphne Louise Piercy | Nurse Practitioner | 117 W Main St, Camargo, IL 61919-3312 | 2005-08-15 |
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|---|---|---|---|---|
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| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
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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.