Active NPI
William Thurman Shipley Sr., D.D.S M.S.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cookeville, TN
National Provider Identifier
1902807142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS 1549
- Practice address
- 303 N Oak Ave
Cookeville, TN 38501-2439 - Phone
- (931) 526-7846
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS 1549 | TN | Primary |
Addresses
Primary practice location
303 N Oak Ave
Cookeville, TN 38501-2439
Mailing address
303 N Oak Ave
Cookeville, TN 38501-2439
Phone (931) 526-7846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SH 3201385 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS 1549 | TN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309910400000",
"number": "1902807142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N OAK AVE",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012439",
"telephone_number": "931-526-7846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N OAK AVE",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012439",
"telephone_number": "931-526-7846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPLEY",
"first_name": "WILLIAM",
"middle_name": "THURMAN",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "D.D.S M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2011-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TN",
"license": "DS 1549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SH 3201385",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.