Active NPI
John Russell Shipp, DC
- Chiropractor
- Little Rock, AR
National Provider Identifier
1104896661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 15711
- Practice address
- 202 S Cross St
Little Rock, AR 72201-1910 - Phone
- (501) 244-2400
- Fax
- (501) 244-2401
- NPI assigned
- Jan 25, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15711 | AR | Primary |
Addresses
Primary practice location
202 S Cross St
Little Rock, AR 72201-1910
Mailing address
1340 Creek Valley Dr
Collierville, TN 38017-1372
Phone (501) 515-4550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15711 | AR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375056000000",
"number": "1104896661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 CREEK VALLEY DR",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380171372",
"telephone_number": "501-515-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S CROSS ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722011910",
"telephone_number": "501-244-2400",
"fax_number": "501-244-2401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPP",
"first_name": "JOHN",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2013-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "15711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.