Active NPI
William H Shipley Jr., DDS
- General Practice Dentistry
- Cape Girardeau, MO
National Provider Identifier
1063776748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2015042866
- Practice address
- 2143 Independence St Ste 101
Cape Girardeau, MO 63703-5824 - Phone
- (573) 206-9531
- NPI assigned
- Jun 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2015042866 | MO | Primary |
Addresses
Primary practice location
2143 Independence St Ste 101
Cape Girardeau, MO 63703-5824
Mailing address
2143 Independence St Ste 101
Cape Girardeau, MO 63703-5824
Phone (573) 206-9531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 1, 2016 through Feb 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015042866 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588204800000",
"number": "1063776748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2143 INDEPENDENCE ST STE 101",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035824",
"telephone_number": "573-206-9531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2143 INDEPENDENCE ST STE 101",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035824",
"telephone_number": "573-206-9531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPLEY",
"first_name": "WILLIAM",
"middle_name": "H",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-27",
"last_updated": "2020-04-30",
"certification_date": "2020-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2015042866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.