Individual provider Active NPI

Julia Katherine Shipman, D.O.

  • Adult Medicine Physician
  • Stuart, FL
National Provider Identifier
1972565414
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS8759 Issued in FL
Practice address
3501 SE Willoughby Blvd.
Stuart, FL 34997
Phone
(772) 288-0304
Fax
(772) 288-1371
NPI assigned
Apr 3, 2006
Last updated
Aug 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X OS8759 FL Primary

Addresses

Primary practice location

3501 SE Willoughby Blvd.
Stuart, FL 34997

Mailing address

3501 SE Willoughby Blvd.
Stuart, FL 34997
Phone (772) 288-0304

Other identifiers 1

IdentifierTypeStateIssuer
270476500MedicaidFL

Other names 1

  • Julia Katherine Bisel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150618000241 FL Order and Referring Only - Family PracticePractitioner - Family Practice 7618955378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS8759FLMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiopulmonary Associates of the Treasure Coast PA Past Accepting new patients

Organizations & group practices 1

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1972565414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SE WILLOUGHBY BLVD.",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34997",
            "telephone_number": "772-288-0304",
            "fax_number": "772-288-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SE WILLOUGHBY BLVD.",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34997",
            "telephone_number": "772-288-0304",
            "fax_number": "772-288-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "JULIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS8759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270476500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "BISEL",
            "middle_name": "KATHERINE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.