KATHERINE MARIE SHEPHARD (PT, DPT) – Physical Therapist, NPI 1033646922

KATHERINE MARIE SHEPHARD (PT, DPT) is a healthcare provider. based in Falcon heights, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 10446 (MN). The NPI Number for KATHERINE MARIE SHEPHARD (PT, DPT) is 1033646922

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE MARIE SHEPHARD (PT, DPT)
NPI
1033646922
Phone
(651) 300-9079
Address
1790 Holton St
Enumeration Date
22 May 2017
Last Update Date
23 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6517703320
Graduation Year
2016 (10 years ago)
PAC ID
7911278809
Group Practice PAC ID
1355396110
Professional Enrollment ID
I20170811000166
Address ID
MN551091243MA2945XSTXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,109 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

Provider Addresses for KATHERINE MARIE SHEPHARD (PT, DPT)

  • 1790 Holton St

    Falcon Heights, MN 551136224

    Phone: (651) 300-9079

    Type: Location

  • 124th Avenue NW, Coon Rapids, Anoka County, Minnesota, 55433, United States

    COON RAPIDS, MN 554334573

    Phone: (763) 236-7337

    Type: Location

  • 1790, Holton Street, Falcon Heights, Ramsey County, Minnesota, 55113, United States

    FALCON HEIGHTS, MN 551136224

    Phone: (651) 792-6180

    Type: Mailing

  • 1939 MINNEHAHA AVE W STE 100

    SAINT PAUL, MN 551041033

    Phone: (651) 348-7428

    Fax: (651) 348-7432

    Type: Location

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: 2017-08-11

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
I20170811000166IPhysical Therapist In Private PracticeMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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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: 1355396110View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
O B S T E T R I C S/ G Y N E C O L O G YMN
O B S T E T R I C S/ G Y N E C O L O G YMN
-MN
O B S T E T R I C S/ G Y N E C O L O G YMN
Physician AssistantMN
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeNY
Registered Dietitian Or Nutrition ProfessionalMN
O B S T E T R I C S/ G Y N E C O L O G YMN

Reviews

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Frequently asked questions

Where can patients find KATHERINE MARIE SHEPHARD (PT, DPT)'s NPI?
You can confirm KATHERINE MARIE SHEPHARD (PT, DPT) with NPI 1033646922; it appears in the national provider directory.
Is KATHERINE MARIE SHEPHARD (PT, DPT) active in the national directory?
KATHERINE MARIE SHEPHARD (PT, DPT)'s public NPI profile is in an active state.
Does KATHERINE MARIE SHEPHARD (PT, DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for KATHERINE MARIE SHEPHARD (PT, DPT). Clinical services aligned with this taxonomy classification.
Where is KATHERINE MARIE SHEPHARD (PT, DPT)'s primary listing?
We display Falcon Heights, Minnesota because that is what the record indicates for KATHERINE MARIE SHEPHARD (PT, DPT).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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