Jack B Shumate Jr., M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME21390 Issued in FL

Practice address

100 Doctors Dr
Ste B
Panama City, FL 32405-7609

Phone

(850) 872-1300

Fax

(850) 872-9420

NPI assigned

Jun 14, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Jack B Shumate M D P a

  • Medical Specialty Clinic/Center
  • Panama City, FL
  • NPI 1790847077
  Authorized official Same address or phone
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558366955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR",
            "address_2": "STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057609",
            "telephone_number": "850-872-1300",
            "fax_number": "850-872-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR",
            "address_2": "STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057609",
            "telephone_number": "850-872-1300",
            "fax_number": "850-872-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMATE",
        "first_name": "JACK",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME21390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "68004",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Short, LCSW
• Toni Jill Shoup, MASTERS OF SCIENCE I
• Frederick W Shuler, M.D.
• Magdalena F Shuler, M.D., PHD
• Taylor Shuler
• Jaimie Sue Shurden, DNP, APRN, FNP-C
• Jalal K Sidani, DPM
• Antoinette Grace Siegel, OT
• Jordan Xavier Sikes, RBT
• Leah Silver

• Neurology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Neurology Physician in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.