Individual provider Active NPI

Jason H Shook, DDS

  • General Practice Dentistry
  • Hayesville, NC
National Provider Identifier
1164596193
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7326 Issued in NC
Practice address
1847 Hwy 64 Business
Hayesville, NC 28904
Phone
(828) 389-2168
Fax
(828) 389-4827
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7326 NC Primary

Addresses

Primary practice location

1847 Hwy 64 Business
Hayesville, NC 28904

Mailing address

1847 Hwy 64 Business
Hayesville, NC 28904
Phone (828) 389-2168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921000575 NC Order and Referring Only - DentistPractitioner - Dentist 8628385861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7326NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164596193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 HWY 64 BUSINESS",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "28904",
            "telephone_number": "828-389-2168",
            "fax_number": "828-389-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 HWY 64 BUSINESS",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "28904",
            "telephone_number": "828-389-2168",
            "fax_number": "828-389-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "JASON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayesville, NC

Sources for this page

Verify at the official NPI Registry.