JONATHAN HOWARD SHIPLEY MD
NPI 1043012255
Student in an Organized Health Care Education/Training Program in San Jose, CA

Q: What is Jonathan Shipley's NPI number?

The NPI number for Jonathan Shipley is 1043012255. It was assigned to this individual provider in the NPPES registry on March 26, 2025.

Q: What is Jonathan Shipley's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Shipley was last updated on March 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 26, 2025PECOS Enrolled

6620 VIA DEL ORO, SAN JOSE, CA 95119(669) 245-0370 Get Directions Write a Review

NPPES record last updated: March 26, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jonathan Howard Shipley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN HOWARD SHIPLEY MD (NPI 1043012255) is an individual student in an organized health care education/training program in San Jose, California and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043012255

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJONATHAN HOWARD SHIPLEYCredential: MD

Location Address6620 VIA DEL OROSan Jose, CA 95119-1392

Mailing Address6620 Via Del OroSan Jose, CA 95119-1392 · (669) 245-0370

Phone(669) 245-0370

Sole ProprietorNo

Enumeration DateMarch 26, 2025

NPPES CertifiedMarch 26, 2025

✔ NPI 1043012255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6620 VIA DEL ORO, San Jose, CA 95119

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Howard Shipley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.