Jackie Shipman, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12101 Carol LN Ste 101
Fredericksburg, VA 22407-6104

Phone

(540) 741-9300

NPI assigned

May 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jackie.shipman.1@17619.direct.athenahealth.com
• Direct secure messaging: jshipman138380@marywashingtonhealthcare.direct-ci.com

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.

• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879
  Medicare reassignment NPD
• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  NPD
• Pathology Associates of Fredericksburg PTR

  • Anatomic Pathology Physician
  • Fredericksburg, VA
  • NPI 1033150982
  NPD

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1487399663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 NW 9TH ST STE 1100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021015",
            "telephone_number": "405-272-7494",
            "fax_number": "405-272-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 CAROL LN STE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076104",
            "telephone_number": "540-741-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 NW 9th St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731021015",
            "country_code": "US",
            "telephone_number": "405-231-3000",
            "fax_number": "405-321-3073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "JACKIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101286384",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Shiffert, PA
• Shiftless Wanderer LLC
• Wan Shin, M.D.
• Hasnain Mohammad Shinwari
• Zachary Ryan Shipe
• Jessica Nichole Shipman
• Randall Shipp, CMT
• Debra Marie Shirt, SLP
• Jennifer Sholtis, NP
• Caeley Ann Short

• Student in an Organized Health Care Education/Training Program in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.