MRS. LARA JENKINS SHEPHERD (CCC-A) – Audiologist, NPI 1902121874

MRS. LARA JENKINS SHEPHERD (CCC-A) is a healthcare provider. based in Rogers, Arkansas. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials CCC-A. They hold a License No. A#288 (AR). The NPI Number for MRS. LARA JENKINS SHEPHERD (CCC-A) is 1902121874

Main info

Female
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
MRS. LARA JENKINS SHEPHERD (CCC-A)
NPI
1902121874
Phone
(479) 636-0110
Address
5204 W REDBUD ST
Enumeration Date
2 April 2010
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4796360110
Graduation Year
1997 (29 years ago)
PAC ID
3173894466
Group Practice PAC ID
0648177873
Professional Enrollment ID
I20170804000898
Address ID
AR727588936RO5204XSTXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

74 QUALIFIED AUDIOLOGIST in AR

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Provider Addresses for MRS. LARA JENKINS SHEPHERD (CCC-A)

  • Ear Nose & Throat, 5204, West Redbud Street, Rogers, Benton County, Arkansas, 72758, United States

    ROGERS, AR 727588936

    Phone: (479) 636-0110

    Fax: (479) 631-0491

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-08-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170804000898IQualified AudiologistARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92557Comprehensive hearing and speech recognition test338324$0
92567Test to assess middle ear function152142$0
View full utilization report →

Insurance plans in this area (ZIP 72758)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648177873View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YAR
Internal Medicine, Cardiovascular Disease (Cardiology)MO
Nurse PractitionerAR
Internal Medicine, General PracticeAR
-AR
R H E U M A T O L O G YAR
-AR
-AR
-AR
Nurse PractitionerAR

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Frequently asked questions

What is the standard ID for MRS. LARA JENKINS SHEPHERD (CCC-A) in the U.S.?
In the U.S., MRS. LARA JENKINS SHEPHERD (CCC-A) is identified by NPI 1902121874.
Is MRS. LARA JENKINS SHEPHERD (CCC-A) currently accepting referrals based on NPI status?
Registry metadata lists MRS. LARA JENKINS SHEPHERD (CCC-A) as active.
What does the directory say MRS. LARA JENKINS SHEPHERD (CCC-A) does?
Insurance directories may phrase it differently, but here MRS. LARA JENKINS SHEPHERD (CCC-A) maps to Audiologist. Clinical services aligned with this taxonomy classification.
What city is tied to MRS. LARA JENKINS SHEPHERD (CCC-A)?
The directory associates MRS. LARA JENKINS SHEPHERD (CCC-A) with Rogers, Arkansas. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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