Healthcare Provider Details

I. General information

NPI: 1114842903
Provider Name (Legal Business Name): JAMES L SHEPHERD III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 ELSWICK LN
CHARLOTTE NC
28214-2412
US

IV. Provider business mailing address

1527 ELSWICK LN
CHARLOTTE NC
28214-2412
US

V. Phone/Fax

Practice location:
  • Phone: 704-737-3907
  • Fax: 704-270-9504
Mailing address:
  • Phone: 704-737-3907
  • Fax: 704-270-9504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: