Provider Demographics
NPI:1376514828
Name:SHEPHERD, BILLIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:ANN
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:ANN
Other - Last Name:SHEPHERD-NOBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1100 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2576
Mailing Address - Country:US
Mailing Address - Phone:828-273-9613
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2576
Practice Address - Country:US
Practice Address - Phone:828-273-9613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC55229207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080084004OtherRR MEDICARE
561647343FOtherCIGNA HEALTHCARE
NC75673OtherBCBS
NC8975673Medicaid
0170725OtherUNITED HEALTHCARE
G06026Medicare UPIN
080084004OtherRR MEDICARE