MISS JACQUELINE SHEPARD
NPI 1003686908
Physician Assistant in Fort Wayne, IN
About Miss Jacqueline Shepard NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISS JACQUELINE SHEPARD (NPI 1003686908) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10004291A) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fort Wayne.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Miss Jacqueline Shepard is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WAYNE, IN 46804
FORT WAYNE, IN 46804
FORT WAYNE, IN 46804
FORT WAYNE, IN 46804
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacqueline Shepard's NPI number?
The NPI number for Jacqueline Shepard is 1003686908. It was assigned to this individual provider in the NPPES registry on January 3, 2024.
Where is Jacqueline Shepard located?
Jacqueline Shepard practices at 7950 W Jefferson Blvd, Fort Wayne, IN 46804. The listed phone number is (260) 435-7001.
What is Jacqueline Shepard's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Jacqueline Shepard enrolled in Medicare?
Yes. Jacqueline Shepard is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jacqueline Shepard was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Miss Jacqueline Shepard · NPI 1003686908
Physician Assistant physician in Fort Wayne, Indiana. Individual provider, active in the CMS NPPES registry since January 3, 2024.
## Identity
- **NPI:** 1003686908 (Entity type: Individual)
- **Enumerated:** January 3, 2024
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **Sole proprietor:** No
## Practice location
- **Address:** 7950 W JEFFERSON BLVD, Fort Wayne, IN 46804-4140
- **Phone:** (260) 435-7001
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 30, 2026
- **Other identifiers:** Medicaid 0065613 (OH)
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Source: [NPI Profile](https://npiprofile.com/npi/1003686908) · Data from the CMS NPPES public registry.