Individual provider Active NPI

Chasity A Shipman

  • Prosthetic/Orthotic Supplier
  • Irmo, SC
National Provider Identifier
1053046896
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
70244 Issued in SC
Practice address
1144 Moseley Ave
Irmo, SC 29063-2787
Phone
(803) 244-9369
NPI assigned
Jul 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 70244 SC Primary

Addresses

Primary practice location

1144 Moseley Ave
Irmo, SC 29063-2787

Mailing address

266 Caedmons Creek Dr
Irmo, SC 29063-7100
Phone (803) 528-0031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
70244SCMDProsthetic/Orthotic Supplier

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1053046896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 CAEDMONS CREEK DR",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290637100",
            "telephone_number": "803-528-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 MOSELEY AVE",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632787",
            "telephone_number": "803-244-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "CHASITY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "70244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.