BRENT SHEPHERD (M.D.) – Family Medicine Physician, NPI 1164687620

BRENT SHEPHERD (M.D.) is a healthcare provider. based in Jacksboro, Texas. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. N6660 (TX). The NPI Number for BRENT SHEPHERD (M.D.) is 1164687620

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
BRENT SHEPHERD (M.D.)
NPI
1164687620
Phone
(940) 567-5528
Address
215 CHISHOLM TRL
Enumeration Date
24 July 2008
Last Update Date
26 December 2018

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Secondary Phone
4323362058
Graduation Year
2008 (18 years ago)
PAC ID
6901081314
Group Practice PAC ID
3173977477
Professional Enrollment ID
I20110429000123
Address ID
TX797350000FO387XXIHXX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for BRENT SHEPHERD (M.D.)

  • 215 CHISHOLM TRL

    JACKSBORO, TX 764581403

    Phone: (940) 567-5528

    Type: Location

  • 109, Valle Court, Azle, Tarrant County, Texas, 76020, United States

    AZLE, TX 76020

    Phone: (817) 287-1264

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $84.

Total Amount is formed as General ($84) + Research ($0) + Ownership ($0) = $84.

Last reported payment date: 2024-03-26 • Largest payer in this snapshot: ABBVIE INC. ($84).

Total Amount

$84

General + Research + Ownership

Payments

3

Total payment records

General Amount

$84

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$84
View all Open Payments →|Open Payments Risk Radar →

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: 2011-04-29

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
I20110429000123IFamily PracticeTXTBD

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
G0179Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a6428$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and2927$0
View full utilization report →

Insurance plans in this area (ZIP 76458)

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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: 3173977477View full group profile
NameSpecialtyState
Emergency MedicineTX
Interventional Radiology, Diagnostic RadiologyCO
Emergency MedicineNY
Emergency MedicineGA
Emergency MedicineTX
Diagnostic Radiology, Interventional RadiologyTX
Diagnostic RadiologyOH
Family PracticeTX
Certified Registered Nurse Anesthetist (Crna)TX
Emergency MedicineVA

Reviews

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Frequently asked questions

What is the 10-digit NPI for BRENT SHEPHERD (M.D.)?
BRENT SHEPHERD (M.D.) — NPI 1164687620 — is the standard way to identify this listing.
Does the file indicate BRENT SHEPHERD (M.D.) is practicing under active NPI?
Directory data currently reports BRENT SHEPHERD (M.D.) as active.
What taxonomy line describes BRENT SHEPHERD (M.D.)?
For research purposes, treat BRENT SHEPHERD (M.D.) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is BRENT SHEPHERD (M.D.) based?
BRENT SHEPHERD (M.D.) is tied to Jacksboro, Texas in the data we show; additional addresses may exist on the full record.
Is the information about BRENT SHEPHERD (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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