DR. WALTER PHILIP SHEPHERD (NPI# 1245391887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245391887 |
| Entity Type | Individual |
| Full Name | DR. WALTER PHILIP SHEPHERD |
| Credential | PHD |
| Practice Address |
2149 Mango Pl Jacksonville FL 32207-3325 |
| Practice Telephone | 9043460092 |
| Practice Fax Number | 9043460586 |
| Mailing Telephone | 9043460092 |
| Mailing Fax Number | 9043460586 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY0003000 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023130275 | Walter Neal Shepherd | Dentist | 3285 Blazer Parkway, Suite 110, Lexington, KY 40509 | 2007-04-06 |
| 1871696427 | Walter Brian Shepherd | Dentist | 113 E Moore St, Eden, NC 27289 | 2006-09-07 |
| Street Address |
2149 MANGO PL |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-3325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649332040 | Gary Warren Buffone | Psychologist | 2149 Mango Pl, Jacksonville, FL 32207-3325 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740224 | North Florida Collaborative Therapy | Psychologist | 9652 Morgan Creek Ct, Jacksonville, FL 32222-5808 | 2020-11-05 |
| 1306456058 | Southern Oregon Cbt LLC | Psychologist | 690 G St Ste C, Jacksonville, OR 97530-3208 | 2020-08-07 |
| 1013408004 | Marisa Victoria Byles | Psychologist | 12443 San Jose Blvd Ste 202, Jacksonville, FL 32223-8648 | 2018-05-24 |
| 1306203245 | Robin Jones | Psychologist | 200 Valencia Dr Ste 194, Jacksonville, NC 28546-6311 | 2016-01-22 |
| 1336510452 | Nour Mahmoud Abdelghani | Psychologist | 524 Skymarks Dr Unit 5, Jacksonville, FL 32218-7254 | 2015-10-15 |
| 1295105823 | Mhealthcare Co. | Psychologist | 3805 Valencia Rd, Jacksonville, FL 32205-9271 | 2015-09-24 |
| 1629406400 | Max Aaron Horovitz | Psychologist | 10475 Centurion Pkwy N Ste 301, Jacksonville, FL 32256-5004 | 2013-10-14 |
| 1457786915 | Coral Gaffney | Psychologist | 6488 103rd St., Ste B, Jacksonville, FL 32210 | 2013-09-03 |
| 1801236542 | Jeffrey Allan Rommel | Psychologist | 11150 Castlemain Cir S, Jacksonville, FL 32256-4825 | 2013-06-26 |
| 1326483017 | Amy Melinda Hartley | Psychologist | 8355 Merchants Gate Dr, Jacksonville, FL 32222-5848 | 2013-05-08 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on DR. WALTER PHILIP SHEPHERD.
| 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.