Jackie L Shipman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39741 Issued in OK

Practice address

101 S Park LN Ste 200
Altus, OK 73521-5731

Phone

(580) 379-6140

Fax

(580) 379-6149

NPI assigned

May 2, 2022

Last updated

Sep 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary Washington Hospital, Inc.

  dba Mary Washington Cardiology

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Obstetrics

  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": "1790035200000",
    "number": "1487399663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5000",
            "fax_number": "580-379-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S PARK LN STE 200",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215731",
            "telephone_number": "580-379-6140",
            "fax_number": "580-379-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OK",
            "license": "39741",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101286384",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "39741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JackieShipman@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "101 S Park Ln Ste 200",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nichole Lynn Shaw, OTA
• Jon Shelton, PHARM D
• Lisa Michelle Shelton, PHARMD
• Carol Marie Sherman, DO
• Stanley Robert Sherman, D.O.
• Kirstie Lea Shive, MSPT
• Shortgrass Community Health Center, Inc
• Tom H Shurley, M.D.
• Julianne Rodgers Shytle, PHARMD
• San Juanita Silva, FSP

• Family Medicine Physician in Altus, OK
• Providers in Altus, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.