Jack B Shumate M D P a

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME21390 Issued in FL

Legal business name

JACK B SHUMATE M D P A

Practice address

100 Doctors Dr
Ste. B
Panama City, FL 32405-7608

Phone

(850) 872-1300

Fax

(850) 872-9420

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jack B Shumate

Title

Physician

Phone

(850) 872-1300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790847077",
    "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": "324057608",
            "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": "324057608",
            "telephone_number": "850-872-1300",
            "fax_number": "850-872-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK B SHUMATE M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUMATE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-872-1300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME21390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Ives, BCBA
• Deborah Ivey, ARNP
• Ivy Spine & Orthopedics, LLC
• Lynette Ivy, PTA
• Kavita Iyengar, MD
• Terri Aminah Jackson-Niiquaye, M.D.
• Briana Jackson
• Bryce V Jackson, M.D.
• Tameka Jackson
• Tasha Ann Jackson, LCSW

• Medical Specialty Clinic/Center in Panama City, FL
• Providers in Panama City, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.