MR. JARED C. SHIPLEY (NPI# 1174154256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174154256 |
Entity Type | Individual |
Full Name | MR. JARED C. SHIPLEY |
Credential | PA |
Practice Address |
5520 Stewart St Milton FL 32570-4304 |
Mailing Address |
2315 W Jackson St Pensacola FL 32505-7552 |
Practice Telephone | 8509819433 |
Practice Fax Number | 8509819436 |
Mailing Telephone | 8504364630 |
Mailing Fax Number | 8504362095 |
Enumeration Date | 2020-01-28 |
Last Update Date | 2020-03-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
9112971 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCCPA | 1171095 | 01 | |
FL | FLORIDA BOARD OF MEDICINE | 9112971 | 01 |
FL | BCBS FL | 2PV1U | 01 |
FL | PENDING | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194933770 | Jared Adam Shipley | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2007-05-18 |
Street Address |
5520 STEWART ST |
City | MILTON |
State | FL |
Zip Code | 32570-4304 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780646745 | Diane Carolyn Hudson | Family Medicine | 5520 Stewart St, Milton, FL 32570-4304 | 2006-04-05 |
1619321650 | Ashley Jones Mcdaniel | Social Worker | 5520 Stewart St, Milton, FL 32570 | 2016-04-15 |
1619335809 | Andrea Nutt | Social Worker | 5520 Stewart St, Milton, FL 32570-4304 | 2016-02-03 |
1194058826 | April Belle Archer | Nurse Practitioner | 5520 Stewart St, Milton, FL 32570-4304 | 2009-09-14 |
1689864035 | Escambia Community Clinics, Inc | Clinic/Center | 5520 Stewart St, Milton, FL 32570-4304 | 2007-07-31 |
1528272168 | Charlene Rogers Echols | Nurse Practitioner | 5520 Stewart St, Milton, FL 32570-4304 | 2007-05-10 |
1962627000 | Melissa Kay Pocta | Family Medicine | 5520 Stewart St, Milton, FL 32570-4304 | 2007-04-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902365604 | Megan Lasure | Behavior Technician | 5950 Berryhill Medical Park Dr Ste B, Milton, FL 32570 | 2019-03-13 |
1104328681 | Katherine Smith Lockler | Foster Care Agency | 6357 Brigadier Road, Milton, FL 32570 | 2018-03-01 |
1750565768 | Emerald Coast Surgical Specialists Pa | Surgery | 5992 Berryhill Road, 203, Milton, FL 32570 | 2007-12-27 |
1285815662 | Chandria Lynn Johnson Md Pa | Obstetrics & Gynecology | 5950 Berryhill Medical Park Dr, Suite B, Milton, FL 32570 | 2007-11-14 |
1659590255 | Medical Associates Ltd | Specialist | 5950 Berryhill Medical, Milton, FL 32570 | 2007-04-24 |
1255404620 | Jonathan E Fountain Md | Family Medicine | 5976 Berryhill Rd, Milton, FL 32570 | 2006-11-15 |
1043317530 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 6501 Caroline St Hwy 90, Milton, FL 32570 | 2006-09-19 |
1497764484 | Jennfer A Godfrey | Speech-Language Pathologist | 5165 Canal Street, Milton, FL 32570 | 2006-08-07 |
1316977135 | Rural Metro of North Florida Inc | Ambulance | 4930 Glover Lane, Milton, FL 32570 | 2006-07-04 |
1558304519 | Pensacola Nephrology Pa | Specialist | 5934 Berryhill Medical Park Dr, Suite 1, Milton, FL 32570 | 2006-06-14 |
Find all providers in zip 32570 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659635829 | Susan Rene Ferguson | Physician Assistant | 5982 Berryhill Rd, Suite B, Milton, FL 32570-4001 | 2012-07-02 |
1346202595 | Michelle Douglas | Physician Assistant | 5825 Highway 90, Milton, FL 32583-1763 | 2006-04-04 |
1215407960 | Taylor Haines White | Physician Assistant | 5907 Berryhill Rd, Milton, FL 32570-8278 | 2018-11-26 |
1053848788 | Ashley Poole | Physician Assistant | 611 Federal St Ste 3, Milton, DE 19968-1157 | 2017-05-12 |
1477090470 | Caitlin Chantae Mosley | Physician Assistant | 5992 Berryhill Rd, Suite 302, Milton, FL 32570-1013 | 2017-01-27 |
1346609450 | Matthew Sorsby | Physician Assistant | 5907 Berryhill Rd, Milton, FL 32570-8278 | 2016-02-17 |
1073940615 | Kayleen M Moore | Physician Assistant | 100 Highland St, Suite 300, Milton, MA 02186-3881 | 2013-09-27 |
1982037438 | Nnenna O Onyemauwa | Physician Assistant | 5907 Berryhill Rd, Milton, FL 32570-8278 | 2013-08-19 |
1477828614 | Tiana Natal Nygaard | Physician Assistant | 5992 Berryhill Rd, 300, Milton, FL 32570-1013 | 2012-03-21 |
1235380601 | Barry F Canavan | Physician Assistant | 100 Highland St, Suite 222, Milton, MA 02186-3881 | 2008-10-03 |
Find all providers in MILTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.