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NPI Code Detail

MEDICARE: CLARICIA SIMMONS SHEPHERD MD

MEDICARE: CLARICIA SIMMONS SHEPHERD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician10349NV
2207Q00000XFamily Medicine PhysicianA78787CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518930098
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARICIA SIMMONS SHEPHERD MD
Provider Business Mailing Address
First Line : 3325 RESEARCH WAY
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7913
Country : US
Telephone Number : 702-383-1961
Fax Number : 702-319-6147
Provider Business Practice Location Address
First Line : 1799 MOUNT MARIAH DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-1501
Country : US
Telephone Number : 702-383-1961
Fax Number : 702-319-6147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 01/06/2025

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Directions to “ CLARICIA SIMMONS SHEPHERD MD” Practice Location

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