Individual provider Active NPI

Jessalyn Shipp

  • Physician Assistant
  • Bowling Green, MO
National Provider Identifier
1790648566
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2026005573 Issued in MO
Practice address
2106 W Main St
Bowling Green, MO 63334-1049
Phone
(816) 589-6958
NPI assigned
Dec 8, 2025
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085012333 IL
Physician Assistant 363A00000X 2026005573 MO Primary

Addresses

Primary practice location

2106 W Main St
Bowling Green, MO 63334-1049

Mailing address

400 SW Longview Blvd Ste 280
Lees Summit, MO 64081-2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260311001774 MO Practitioner - Physician Assistant 9133602832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CH Specialty Services Mo LLCGroup PAC ID 0345614459, 108 clinicians
Curana Health of Missouri-Kansas LLCGroup PAC ID 4789716531, 143 clinicians

Practice addresses (Care Compare)

1 New Ballas PL
Saint Louis, MO 63146-8700
Phone (337) 991-9276

2 Emanuel Cleaver II Blvd
Kansas City, MO 64112-1654
Phone (337) 991-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026005573MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services Mo LLC CurrentSince Feb 24, 2026 Accepting new patients
Curana Health of Missouri-Kansas LLC CurrentSince Feb 24, 2026 Accepting new patients

Locations

2106 W Main St
Bowling Green, MO 63334
Phone (573) 324-2216

385 S Eisenhower St
Monett, MO 65708
Phone (417) 235-4040

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1790648566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 280",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 W MAIN ST",
            "city": "BOWLING GREEN",
            "state": "MO",
            "postal_code": "633341049",
            "telephone_number": "816-589-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "JESSALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085012333",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2026005573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, MO

Sources for this page

Verify at the official NPI Registry.