Active NPI
Jacqueline Nguyen Shimamoto, MD
- Pediatrics Physician
- Bastrop, TX
National Provider Identifier
1326740523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- W8095
- Practice address
- 605 Old Austin Hwy
Bastrop, TX 78602-5034 - Phone
- (877) 800-5722
- NPI assigned
- Mar 20, 2023
- Last updated
- Sep 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pediatrics Physician | 208000000X | W8095 | TX | Primary |
Addresses
Primary practice location
605 Old Austin Hwy
Bastrop, TX 78602-5034
Mailing address
2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722
Other practice location 1
3950 N A W Grimes Blvd Ste N201
Round Rock, TX 78665-3540
Phone (877) 800-5722
Other practice location 2
757 Westwood Plaza Box 951752, 3108 Rrumc
Los Angeles, CA 90095-8358
Phone (310) 267-9124
Other practice location 3
2423 Williams Dr Ste 103
Georgetown, TX 78628-3200
Phone (877) 800-5722
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)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1326740523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2423 WILLIAMS DR STE 107",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786283269",
"telephone_number": "877-800-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 OLD AUSTIN HWY",
"city": "BASTROP",
"state": "TX",
"postal_code": "786025034",
"telephone_number": "877-800-5722"
}
],
"practiceLocations": [
{
"address_1": "3950 N A W Grimes Blvd Ste N201",
"address_purpose": "LOCATION",
"city": "Round Rock",
"state": "TX",
"postal_code": "786653540",
"country_code": "US",
"telephone_number": "877-800-5722",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "757 Westwood Plaza Box 951752, 3108 Rrumc",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900958358",
"country_code": "US",
"telephone_number": "310-267-9124",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2423 Williams Dr Ste 103",
"address_purpose": "LOCATION",
"city": "Georgetown",
"state": "TX",
"postal_code": "786283200",
"country_code": "US",
"telephone_number": "877-800-5722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIMAMOTO",
"first_name": "JACQUELINE",
"middle_name": "NGUYEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "W8095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, TX
- Victor K Seghers, MD
- Serenity Hospice Atx, LLC (Serenity Hospice)
- Diane Merril Shaktman, MD
- Erin Shehu, M.S., CCC-SLP
- Sheri Hatt (Rogue Prosthetics & Consulting Services)
- Laura Marie Sieber, MD
- Signature Smiles of Bastrop
- Silver Pines Nursing and Rehabilitation LP
- Karan Singh, DPT
- Skipol Inc (Bastrop Back & Neck Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.