Jerry Shipman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

101242 Issued in NC

Practice address

201 Stevens Mill Rd
Goldsboro, NC 27530-1056

Phone

(919) 731-3206

NPI assigned

Aug 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Roanoke Chowan Community Health Center Inc

  dba Colerain Primary Care

  • Federally Qualified Health Center (FQHC)
  • Colerain, NC
  • NPI 1790851004
  Medicare reassignment
• Roanoke Chowan Community Health Center Inc

  dba Woodland Primary Care

  • Federally Qualified Health Center (FQHC)
  • Woodland, NC
  • NPI 1023675113
  NPD
• Roanoke Chowan Community Health Center Inc

  dba Murfreesboro Primary Care

  • Federally Qualified Health Center (FQHC)
  • Murfreesboro, NC
  • NPI 1497776470
  NPD

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275545584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N MARION DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275347612",
            "telephone_number": "919-751-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STEVENS MILL RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301056",
            "telephone_number": "919-731-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelanda Shearod
• Juqetta Sheffield, FNP
• William C Shepherd Jr., PMHNP-BC
• Nikita Danielle Sherard, PHARMD
• Steven Christopher Sherrouse, LCSW
• Karen Shoemake
• Barbara H. Shoestock, OTR/L
• Ajay Iyengar Shreenath, MD
• Simmons Early Intervention Therapy, LLC
• Millicent Murray Simmons, RD, LDN

• Physician Assistant in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.