DR. JONATHAN PAUL SHEPHERD (NPI# 1114048329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114048329 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN PAUL SHEPHERD |
| Credential | M.D. |
| Practice Address |
114 Woodland St Dept Of Hartford CT 06105-1208 |
| Mailing Address |
114 Woodland St. Department of Ob Gyn Hartford CT 06105 |
| Practice Telephone | (860) 714-4595 |
| Practice Fax Number | 8607148008 |
| Mailing Telephone | 8607144595 |
| Mailing Fax Number | 8607148008 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2018-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 55313 | CT | Allopathic & Osteopathic Physicians |
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
269626 | MA | Allopathic & Osteopathic Physicians |
| Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
55313 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110128968A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902096050 | Jonathan Joel Shepherd | Psychiatry & Neurology | 6707 Whitestone Rd, Suite 106, Woodlawn, MD 21207-4106 | 2007-07-25 |
| Street Address |
114 WOODLAND ST DEPT OF |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285153627 | Melissa Raquel Ramirez | Physician Assistant | 114 Woodland St Dept Of, Hartford, CT 06105-1208 | 2017-09-18 |
| 1740630417 | Muhammad Fahd Farooq | Hospitalist | 114 Woodland St Dept Of, Hartford, CT 06105-1208 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1730743568 | Turab J Mohammed | Student in an Organized Health Care Education/Training Program | Saint Francis Hospital Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2019-04-26 |
| 1164900387 | Breanne Ferrara | Social Worker | 43 Wooland St, Hartford, CT 06105 | 2018-07-31 |
| 1154814069 | Signature Smiles of Hartford LLC | Dentist | 550 Farmington Avenue, Suite B, Hartford, CT 06105 | 2018-06-14 |
| 1356839062 | Jaimy Villavicencio | Student in an Organized Health Care Education/Training Program | 100 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2018-04-27 |
| 1750885679 | Brittany Bird | Student in an Organized Health Care Education/Training Program | 839-841 Asylum Avenue, Hartford, CT 06105 | 2018-03-23 |
| 1972032241 | Ashley Nicole Mills | Student in an Organized Health Care Education/Training Program | 896 Asylum Ave, 3rd Floor, Hartford, CT 06105 | 2017-06-08 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1841735818 | Katie Strahowski | Nurse Practitioner | 85 Gillett Street, Clean Slate, Hartford, CT 06105 | 2016-12-30 |
| Find all providers in zip 06105 | ||||
| Taxonomy Code | 207VF0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114007770 | Katherine S Sandhu | Obstetrics & Gynecology | 292 Long Ridge Rd, Suite 202, Stamford, CT 06902-1627 | 2006-10-17 |
| 1982791505 | Oz Harmanli | Obstetrics & Gynecology | 800 Howard Ave, 3rd Floor, New Haven, CT 06519-1369 | 2006-10-06 |
| 1982613659 | Brian J Hines | Obstetrics & Gynecology | 292 Long Ridge Rd, Suite 202, Stamford, CT 06902-1627 | 2006-08-05 |
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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.