NPIMap

Individual provider Active NPI

Jennifer Monique Shoemaker, MD

  • Family Medicine Physician
  • Jackson, CA
National Provider Identifier
1952613028
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A135203 Issued in CA
Practice address
815 Court St Ste 7
Jackson, CA 95642-2154
Phone
(209) 223-2034
Fax
(209) 223-2038
NPI assigned
Jul 6, 2010
Last updated
Feb 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A135203 CA Primary

Addresses

Primary practice location

815 Court St Ste 7
Jackson, CA 95642-2154

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other practice location 1

9279 Locust St.
Plymouth, CA 95669
Phone (209) 245-6968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160926000419 CA Practitioner - Family Practice 2264655364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

100 Mission Blvd
Jackson, CA 95642-2536

2 Medical Plaza Dr
Roseville, CA 95661-3042

2800 L St
Sacramento, CA 95816-5616

3100 Douglas Blvd
Roseville, CA 95661-3866
Phone (916) 774-8500

815 Court St
Jackson, CA 95642-2154

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A135203CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Aug 29, 2016 Accepting new patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Sutter Regional Medical Foundation Family Medicine Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jshoemaker170889@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1952613028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 COURT ST STE 7",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422154",
            "telephone_number": "209-223-2034",
            "fax_number": "209-223-2038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9279 Locust St.",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "CA",
            "postal_code": "95669",
            "country_code": "US",
            "telephone_number": "209-245-6968",
            "fax_number": "209-245-5135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "JENNIFER",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A135203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

Verify at the official NPI Registry.