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SAMUEL LEE SHEPARD
NPI 1730842840
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since October 15, 2021PECOS Enrolled
405 W GRAND AVE, DAYTON, OH 45405(937) 723-3200 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel Lee Shepard NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL LEE SHEPARD (NPI 1730842840) is an individual student in an organized health care education/training program in Dayton, Ohio and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730842840
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL LEE SHEPARD
Location Address405 W GRAND AVEDayton, OH 45405-7538
Mailing Address1111 W 17th StTulsa, OK 74107-1886 · (918) 919-9924
Phone(937) 723-3200
Sole ProprietorYes
Enumeration DateOctober 15, 2021
Last NPPES UpdateMarch 19, 2024
NPPES CertifiedMarch 19, 2024
✔ NPI 1730842840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
405 W GRAND AVE, Dayton, OH 45405
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Lee Shepard is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

LARA MARTINEZ
Emergency Medicine
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3245
ANDREW JORDAN KRISTUFEK DO
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
DR. JASON DWIGHT MCINTOSH D.O.
Emergency Medicine
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
WHITNEY J CRYE D.O.
Obstetrics & Gynecology
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3567
SARAH BLESCH
Nurse Anesthetist, Certified Registered
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3200
ALEXANDRA D BREZOVEC
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
RONALD TRAN DO
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3200
DR. CHARLES OSBORNE DUNCAN II DO
Internal Medicine
405 W GRAND AVE, C/O MEDICAL EDUCATION
DAYTON, OH 45405
Montgomery County (937) 723-3248

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 Samuel Shepard's NPI number?

The NPI number for Samuel Shepard is 1730842840. It was assigned to this individual provider in the NPPES registry on October 15, 2021.

Where is Samuel Shepard located?

Samuel Shepard practices at 405 W Grand Ave, Dayton, OH 45405. The listed phone number is (937) 723-3200.

What is Samuel Shepard's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Shepard enrolled in Medicare?

Yes. Samuel Shepard is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Shepard was last updated on March 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.