Richelle D Shipman, CRNP
Individual provider Active NPI Women's Health Nurse Practitioner · Boardman, OH
NPI 1043370075 · NPPES record last updated Nov 22, 2017
Key facts
- NPI
- 1043370075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Women's Health Nurse Practitioner 363LW0102X
- License
- NP09167 (OH)
- Practice address
- 1111 Boardman Canfield Rd
Boardman, OH 44512-4062 - Phone
- (330) 965-0909
- Fax
- (330) 965-0897
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070110000214 | OH | Practitioner - Nurse Practitioner | 8729088067 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP09167 | OH | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signature Health Inc | Current |
Accepting new patients | |
| Signature Health, Inc. | Current | Accepting new patients | |
| Advanced Women'S Care Inc | Current |
Accepting new patients | |
| Signature Health, Inc | Current |
Accepting new patients | |
| Family Planning Association of Northeast Ohio, Inc. | Past |
Accepting new patients | |
| Planned Parenthood of Greater Ohio | Past | Accepting new patients |
Locations
21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100
7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855
54 S State St
Ste 203
Painesville, OH 44077
Phone (440) 352-0608
1111 Boardman Canfield Rd
Youngstown, OH 44512
Phone (330) 965-0909
Interoperability endpoints
- rshipman327752@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | NP09167 | OH | Yes |
Addresses
Primary practice location
1111 Boardman Canfield Rd
Boardman, OH 44512-4062
Mailing address
1111 Boardman Canfield Rd
Boardman, OH 44512-4062
Phone (330) 965-0909
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0082341 | Medicaid | OH |
Other providers in Boardman, OH
- Shivani Sharma
- Sharpe Builders LLC
- Kelley Shaughnessy
- Suzanne M Shaw
- Lisa Ann Sherban
- Melanie Sue Shoaf
- Daniel W Shobel
- Elizabeth Mary Shobel
- Christopher W Shoemaker
- James Shurtleff
All providers in Boardman, OH · Women's Health Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.