John Dawson Shipp V

Primary specialty

PharmacistTaxonomy code 183500000X

License

029599 Issued in GA

Practice address

206 S Harris St
Sandersville, GA 31082-2665

Phone

(478) 552-0559

NPI assigned

Dec 1, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1023613882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BROOKTON WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417463",
            "telephone_number": "770-846-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S HARRIS ST",
            "city": "SANDERSVILLE",
            "state": "GA",
            "postal_code": "310822665",
            "telephone_number": "478-552-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "JOHN",
        "middle_name": "DAWSON",
        "name_suffix": "V",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "029599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "4785531873",
            "affiliation": "N",
            "endpointDescription": "Pharmacy",
            "address_1": "206 S Harris St",
            "city": "Sandersville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310822665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Raven L Smith
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• Pharmacist in Sandersville, GA
• Providers in Sandersville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.