Active NPI
John Michael Shimko, D.P.M.
- Podiatrist
- Charlotte, NC
National Provider Identifier
1194718619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 270
- Practice address
- 10130 Perimeter Pkwy Ste 200
Charlotte, NC 28216-0197 - Phone
- (888) 849-7379
- Fax
- (855) 857-7333
- NPI assigned
- Aug 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 270 | NC | Primary |
Addresses
Primary practice location
10130 Perimeter Pkwy Ste 200
Charlotte, NC 28216-0197
Mailing address
10130 Perimeter Pkwy Ste 200
Charlotte, NC 28216-0197
Phone (888) 849-7379
Other practice location 1
19453 W Catawba Ave Ste A
Cornelius, NC 28031-4022
Phone (704) 892-3399
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0816H | Other | NC | BLUE CROSS BLUE SHIELD |
| 890816H | Medicaid | NC |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 270 | NC | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Lake Women'S Healthcare PLLC | Past | Accepting new patients |
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.
-
- Obstetrics & Gynecology Physician
- Cornelius, NC
- NPI 1417404401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507766400000",
"number": "1194718619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10130 PERIMETER PKWY STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282160197",
"telephone_number": "888-849-7379",
"fax_number": "855-857-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10130 PERIMETER PKWY STE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282160197",
"telephone_number": "888-849-7379",
"fax_number": "855-857-7333"
}
],
"practiceLocations": [
{
"address_1": "19453 W Catawba Ave Ste A",
"address_purpose": "LOCATION",
"city": "Cornelius",
"state": "NC",
"postal_code": "280314022",
"country_code": "US",
"telephone_number": "704-892-3399",
"fax_number": "704-892-5113",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIMKO",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2017-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NC",
"license": "270",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0816H",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890816H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.