Individual provider Active NPI

Jeffrey Lee Shipman, D.O.

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1982618575
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4436 Issued in OK
Practice address
4200 S Douglas Ave Ste 306
Oklahoma City, OK 73109-3215
Phone
(405) 636-7195
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4436 OK Primary

Addresses

Primary practice location

4200 S Douglas Ave Ste 306
Oklahoma City, OK 73109-3215

Mailing address

1132 SW 127TH PL
Oklahoma City, OK 73170-6950
Phone (405) 703-0743

Other identifiers 1

IdentifierTypeStateIssuer
200105640AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070227000527 OK Practitioner - Emergency Medicine 3274635974 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4436OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Oct 1, 2011 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Oklahoma Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Norstar Emergency Physicians Past Accepting new patients
Lightstar Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Integris South Oklahoma City Hospital Corporation Past Accepting new patients
Washita Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1982618575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 SW 127TH PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706950",
            "telephone_number": "405-703-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S DOUGLAS AVE STE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093215",
            "telephone_number": "405-636-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200105640A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.