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General NPI Number Information
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NPI Number | 1831193796
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Entity Type | Individual
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Provider Name | RON SHEPPARD OT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 2817 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3216
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Country | US
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Telephone | 423-586-4810
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Fax | 276-386-1446
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7568
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Fax | 276-386-1446
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OT00361
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119001450
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 361
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License Number State | TN
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