Individual provider Active NPI

Jonathan Grant Shores, D.C.

  • Chiropractor
  • Panama City, FL
National Provider Identifier
1184916934
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10293 Issued in FL
Practice address
2424 Lisenby Ave
Panama City, FL 32405-3585
Phone
(850) 819-8083
Fax
(850) 848-6666
NPI assigned
May 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10293 FL Primary

Addresses

Primary practice location

2424 Lisenby Ave
Panama City, FL 32405-3585

Mailing address

2424 Lisenby Ave
Panama City, FL 32405-3585
Phone (850) 819-8083

Other practice location 1

11525 Hutchison Blvd Ste 102
Panama City Beach, FL 32407-3749
Phone (850) 819-8083

Other identifiers 1

IdentifierTypeStateIssuer
220EMOtherFLBLUE CROSS BLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shores Chiropractic, LLC Chiropractor Current Accepting new patients

Locations

2424 Lisenby Ave
Panama City, FL 32405
Phone (229) 563-8857

11525 Hutchison Blvd
Ste 102
Panama City Beach, FL 32407
Phone (850) 819-8083

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1184916934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 LISENBY AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053585",
            "telephone_number": "850-819-8083",
            "fax_number": "850-848-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 LISENBY AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053585",
            "telephone_number": "850-819-8083",
            "fax_number": "850-848-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11525 Hutchison Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Panama City Beach",
            "state": "FL",
            "postal_code": "324073749",
            "country_code": "US",
            "telephone_number": "850-819-8083",
            "fax_number": "850-848-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORES",
        "first_name": "JONATHAN",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "220EM",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.