JOHN-JORDAN SHOCKLEY NUNNERY MD
NPI 1114593001
Student in an Organized Health Care Education/Training Program in Jefferson, LA

Active since June 01, 2021PECOS Enrolled
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR, JEFFERSON, LA 70121(504) 842-3260(504) 842-3193 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 3, 2026, Jun 1, 2021 (2 updates tracked since 2021).

About John-jordan Shockley Nunnery Md NPPES

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

JOHN-JORDAN SHOCKLEY NUNNERY MD (NPI 1114593001) is an individual student in an organized health care education/training program in Jefferson, Louisiana and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114593001
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOHN-JORDAN SHOCKLEY NUNNERYCredential: MD
Location Address1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOORJefferson, LA 70121
Mailing Address1215 Lee St, Mail Stop 800719Charlottesville, VA 22908-0816 · (434) 924-2150 · Fax (434) 924-6805
Fax(504) 842-3193
Sole ProprietorNo
Enumeration DateJune 1, 2021
Last NPPES UpdateApril 3, 20262 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
NPI 1114593001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.
1401 A JEFFERSON HIGHWAY, Jefferson, LA 70121

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

John-jordan Shockley Nunnery 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Internal Medicine
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121
Student in an Organized Health Care Education/Training Program
1401 A JEFFERSON HIGHWAY, ACADEMIC CENTER, 1ST FLOOR
JEFFERSON, LA 70121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John-jordan Nunnery's NPI number?

The NPI number for John-jordan Nunnery is 1114593001. It was assigned to this individual provider in the NPPES registry on June 1, 2021.

Where is John-jordan Nunnery located?

John-jordan Nunnery practices at 1401 A Jefferson Highway Academic Center, 1st Floor, Jefferson, LA 70121. The listed phone number is (504) 842-3260.

What is John-jordan Nunnery's specialty?

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

Is John-jordan Nunnery enrolled in Medicare?

Yes. John-jordan Nunnery is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John-jordan Nunnery was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.