JACLYN SURLES SHEPARD (NPI# 1932335486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932335486 |
| Entity Type | Individual |
| Full Name | JACLYN SURLES SHEPARD |
| Credential | PSYD |
| Practice Address |
4 Hospital Dr Charlottesville VA 22908-0001 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 4349245314 |
| Practice Fax Number | 4349240185 |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2012-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810004538 | VA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4 HOSPITAL DR |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22908-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316354541 | Anna L Tate | Nurse Practitioner | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2014-07-21 |
| 1578902946 | Lucy Heinzel Goeke | Nurse Practitioner | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2013-06-19 |
| 1437421823 | Matthew B. Persinger | Physician Assistant | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2012-02-01 |
| 1033410592 | Elizabeth W. Good | Nurse Practitioner | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2010-11-15 |
| 1811156649 | Brendan T. Bowman | Internal Medicine | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2008-06-06 |
| 1609077890 | Carol L. Vincel | Nurse Practitioner | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2007-05-29 |
| 1841407830 | Carlos A Tache-leon | Surgery | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2007-05-17 |
| 1699980540 | Avinash Agarwal | Transplant Surgery | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2007-05-14 |
| 1306067020 | Leigh A. Cantrell | Obstetrics & Gynecology | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2007-05-01 |
| 1518081694 | Patrice Y. Neese | Nurse Practitioner | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2007-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1649702317 | Ryan Aschenbrener | Student in an Organized Health Care Education/Training Program | 545 Ray C Hunt Drive Suite 2400, Charlottesville, VA 22908 | 2017-03-31 |
| 1215399241 | Katherine Gresham Belote | Student in an Organized Health Care Education/Training Program | 1221 Lee Street Uva Health System, Charlottesville, VA 22908 | 2016-03-29 |
| 1851776215 | Catherine Meller | Student in an Organized Health Care Education/Training Program | 1215 Lee St., Box 800713, Charlottesville, VA 22908 | 2015-07-28 |
| 1295112597 | Breanna Campbell | Internal Medicine | 1220 Lee St Ste 2401, Charlottesville, VA 22908 | 2015-05-06 |
| 1013255637 | Melinda Bowles-childress | Nurse Practitioner | 1 Hospital Dr Fl 1, Charlottesville, VA 22908 | 2013-01-17 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1730241282 | Imre Noth | Internal Medicine | 1221 Lee St Fl 2, Charlottesville, VA 22908 | 2006-12-14 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1366401242 | Lisa M Christianson | Obstetrics & Gynecology | Uva Elson Student Health Center, 400 Brandon Avenue, Charlottesville, VA 22908 | 2006-03-21 |
| Find all providers in zip 22908 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033731146 | Matthew Stuart Zimmerman | Psychologist | 977 Kelsey Dr, Charlottesville, VA 22903-7855 | 2020-05-12 |
| 1891282828 | Nino Chkhaidze | Psychologist | 1410 Incarnation Dr # 205, Charlottesville, VA 22901-5708 | 2018-04-16 |
| 1376056317 | Erin E Horn | Psychologist | 302 Park St Ste 204, Charlottesville, VA 22902 | 2017-11-13 |
| 1528570868 | White Oak Counseling, Inc. | Psychologist | 667 Berkmar Ct, Charlottesville, VA 22901-1406 | 2017-10-26 |
| 1013434497 | Latasha Leigh Nadasdi | Psychologist | 223 W Main St Ste F, Charlottesville, VA 22902-5071 | 2017-08-25 |
| 1962859637 | Stephanie D. Bajo | Psychologist | 1 Hospital Dr Fl 6, Charlottesville, VA 22908-0001 | 2016-05-23 |
| 1164807491 | Joanna S Yost | Psychologist | 1 Hospital Dr Fl 4, Charlottesville, VA 22908-0816 | 2015-07-28 |
| 1942640396 | Mindful Health Associates LLC | Psychologist | 408 Hidden Ridge Rd, Charlottesville, VA 22902-7243 | 2013-06-30 |
| 1093054082 | Carly Lynne Mount | Psychologist | 302 Hickman Rd Ste 105, Charlottesville, VA 22911-3572 | 2013-02-11 |
| 1588943526 | Allison Elizabeth Anderson | Psychologist | 1928 Arlington Blvd, Suite 107, Charlottesville, VA 22903-1561 | 2011-08-09 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22908 |
Please comment or provide details below to improve the information on JACLYN SURLES SHEPARD.
| 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.