John H Shackelford Jr., DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

220500 Issued in MA

Practice address

1421 Orleans Rd
Harwich, MA 02645-2148

Phone

(508) 778-4777

Fax

(508) 771-9555

NPI assigned

Mar 22, 2006

Last updated

Jun 17, 2019By 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Medical Affiliates of Cape Cod, Inc.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1770534927
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1598724072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 NORTH ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026015108",
            "telephone_number": "508-862-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 ORLEANS RD",
            "city": "HARWICH",
            "state": "MA",
            "postal_code": "026452148",
            "telephone_number": "508-778-4777",
            "fax_number": "508-771-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "220500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J28724",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104296",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA35717",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle M Ryder, BCBA
• Katrin Sara Sadigh, M.D.
• Dani Schechter
• Rachel Laura Schoenberg
• Mary Claffie Secor, PT
• James White Shepherd III, MD
• Joshua Skolnick
• Judith Skolnick, LCSW, LMSW
• Kathryn M Slater, MSSW, LICSW
• Lisa M Smith, MSPT

• Internal Medicine Physician in Harwich, MA
• Providers in Harwich, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.