Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 519 | NC |
N | 213ES0131X | Foot Surgery | 519 | NC |
NPI | 1326195504 |
---|---|
Provider Name | Dr. James Robert Shipley |
First Address | Mount Airy, NC 27030-4010 |
Second Address | Mount Airy, NC 27030-4010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 18/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326195504 | (05) | NC |
NCA058B699 | MEDICARE PTAN (01) | NC |
P01459103 | RAILROAD MEDICARE (01) | NC |
V12253 | (02) | NC |