John E Shockley, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R5A82 Issued in MO

Practice address

615 SW 3Rd St
Lees Summit, MO 64063-2212

Phone

(816) 524-3799

Fax

(913) 495-3727

NPI assigned

Aug 22, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Lees Summit Clinic Inc

  • Family Medicine Physician
  • Lees Summit, MO
  • NPI 1548252083
  NPD

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1639161003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR STE 220",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141505",
            "telephone_number": "816-524-3799",
            "fax_number": "913-495-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SW 3RD ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632212",
            "telephone_number": "816-524-3799",
            "fax_number": "913-495-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R5A82",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals_elsc@encompassmed.direct-ci.net",
            "affiliation": "Y",
            "affiliationName": "Encompass Medical Group, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "615 SW 3rd St",
            "city": "Lees Summit",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640632212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Syrece Kamille Sherman, DC
• Marie Christine Shilbaya, OTR/L
• Morgan G Shippy, RN, IBCLC
• Kim Shirk, LPC, NCC
• Jami D Shockey, CRNA
• Julie Shoemake, CCC-SLP
• Hannah K Sholar, MA, PLPC, NCC
• Brianna Shuler
• Siamo Health LLC
• Amy Lynn Sickel, PSYD

• Family Medicine Physician in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.