Jacqueline Shepard
Jacqueline Shepard is a Physician Assistant in Fort Wayne, IN, registered under NPI 1003686908.
Getting there
Here is what surrounds this office in Fort Wayne, based on OpenStreetMap data collected Sep 15, 2026. Parking is available about 462 ft away. If you arrive early, there is a coffee shop 248 ft away.
Getting here and what is nearby
Coffee Tim Hortons 248 ft ~1 min
Parking 431 ft ~2 min
Parking 452 ft ~2 min
Parking 462 ft ~2 min
Hotel Residence Inn Fort Wayne 0.35 mi ~8 min
Grocery Scott's 0.38 mi ~8 min
5501 Coventry Lane, Fort Wayne 46804
Hotel Comfort Suites South 0.44 mi ~9 min
Hotel Fairfield Inn & Suites Fort Wayne Southwest 0.44 mi ~9 min
Restaurant Buffalo Wild Wings 0.46 mi ~10 min
5519 Coventry Lane, Fort Wayne 46804
Restaurant Bob Evans 0.47 mi ~10 min
5785 Coventry Lane, Fort Wayne 46804
Restaurant Don Halls 0.50 mi ~11 min
5745 Coventry Lane, Fort Wayne 46804
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 10004291A | IN | Physician Assistant |
This provider holds licence 10004291A issued in IN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Physician Assistant
- PAC ID
- 2062850696
- Enrollment ID
- I20240402002647
Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Physician Assistant covers
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. NUCC Health Care Provider Taxonomy, code 363A00000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | — | — | primary |
| 363A00000X | Physician Assistant | 10004291A | IN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1003686908 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jan 3, 2024 |
| Last updated | Mar 30, 2026 |
| Status | Active |
| Sole proprietor | No |
| Gender | Female |
| Practice address |
7950 W JEFFERSON BLVD Fort Wayne, IN 46804 (260) 435-7001 |
| Mailing address |
5913 HALLOWELL PL Fort Wayne, IN 46815 |
| Other identifiers |
0065613
· Medicaid (OH) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 6 | 8 | 6 | 9 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 3 | 8 | 3 | 9 | 0 |
Sum = 52 · next multiple of 10 = 60 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.