Active NPI
Jacky J Shook, RN
- Internal Medicine Physician
- Westminster, CO
National Provider Identifier
1700913779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 167957
- Practice address
- 7701 Sheridan Blvd
Westminster, CO 80003-2605 - Phone
- (303) 657-6921
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 167957 | CO | Primary |
Addresses
Primary practice location
7701 Sheridan Blvd
Westminster, CO 80003-2605
Mailing address
7701 Sheridan Blvd
Westminster, CO 80003-2605
Phone (303) 466-6133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009979 | Other | KAISER-COMMERCIAL NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 167957 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700913779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 SHERIDAN BLVD",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800032605",
"telephone_number": "303-466-6133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 SHERIDAN BLVD",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800032605",
"telephone_number": "303-657-6921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOOK",
"first_name": "JACKY",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "167957",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER-COMMERCIAL NUMBER",
"identifier": "009979",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Westminster, CO
Sources for this page
- 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.