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JACKIE SHIPMAN MD
NPI 1487399663
Student in an Organized Health Care Education/Training Program in Fredericksburg, VA

Active since May 02, 2022PECOS Enrolled
12101 CAROL LN STE 101, FREDERICKSBURG, VA 22407(540) 741-9300 Get Directions Write a Review

NPPES record last updated: January 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 2, 2026, May 2, 2022 (2 updates tracked since 2022).

About Jackie Shipman Md NPPES

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

JACKIE SHIPMAN MD (NPI 1487399663) is an individual student in an organized health care education/training program in Fredericksburg, Virginia and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Oklahoma City, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1487399663
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJACKIE SHIPMANCredential: MD
Location Address12101 CAROL LN STE 101Fredericksburg, VA 22407-6104
Mailing Address608 Nw 9th St Ste 1100Oklahoma City, OK 73102-1015 · (405) 272-7494 · Fax (405) 272-6985
Phone(540) 741-9300
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMay 2, 2022
Last NPPES UpdateJanuary 2, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2026
✔ NPI 1487399663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 0101286384 (VA)
12101 CAROL LN STE 101, Fredericksburg, VA 22407
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Secondary Practice Location 1

Location 1608 NW 9th St Ste 1100Oklahoma City, OK 73102-1015 · Phone (405) 231-3000 · Fax (405) 321-3073

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackie Shipman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315440807
PECOS Enrollment IDI20260125000107
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.

RACHEL COGGINS
Physical Medicine & Rehabilitation
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
YAA AMOAH-TACHIE MD
Student in an Organized Health Care Education/Training Program
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
MARY CATHLEEN ADAMS
Student in an Organized Health Care Education/Training Program
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
BRIDGET MARIE SMITH DO
Family Medicine
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
SIERRA ASHTON SMITH MD
Family Medicine
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
LUCIE SORELLE TCHUINTE LEKUIKEU MD
Student in an Organized Health Care Education/Training Program
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
DR. JONATHAN KENNETH GONZALEZ MD
Student in an Organized Health Care Education/Training Program
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 741-9300
ABIGAIL RUBIO MD
Student in an Organized Health Care Education/Training Program
12101 CAROL LN STE 101
FREDERICKSBURG, VA 22407
Spotsylvania County (540) 418-6681

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 Jackie Shipman's NPI number?

The NPI number for Jackie Shipman is 1487399663. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Where is Jackie Shipman located?

Jackie Shipman practices at 12101 Carol Ln Ste 101, Fredericksburg, VA 22407. The listed phone number is (540) 741-9300.

What is Jackie Shipman's specialty?

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

Is Jackie Shipman enrolled in Medicare?

Yes. Jackie Shipman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jackie Shipman was last updated on January 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.