Active NPI
Katrina M Shimp, RDH, OMT
- Specialist
- Reidsville, NC
National Provider Identifier
1073225462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 12153
- Practice address
- 201 Piedmont St #632
Reidsville, NC 27320-3869 - Phone
- (717) 639-8996
- NPI assigned
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 12153 | NC | |
| Specialist | 174400000X | 12153 | NC | Primary |
Addresses
Primary practice location
201 Piedmont St #632
Reidsville, NC 27320-3869
Mailing address
201 Piedmont St #632
Reidsville, NC 27320-3869
Phone (336) 496-1636
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12153 | Other | NC | SPECIALIST |
| 12153 | Other | NC | REGISTERED DENTAL HYGIENIST OF NORTH CAROLINA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | katrina@piedmontmyo.com | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12153 | NC | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1073225462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 PIEDMONT ST #632",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273203869",
"telephone_number": "336-496-1636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PIEDMONT ST #632",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273203869",
"telephone_number": "717-639-8996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMP",
"first_name": "KATRINA",
"middle_name": "M",
"credential": "RDH, OMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "12153",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "12153",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIALIST",
"identifier": "12153",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DENTAL HYGIENIST OF NORTH CAROLINA",
"identifier": "12153",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "katrina@piedmontmyo.com",
"affiliation": "N",
"endpointDescription": "Email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "201 Piedmont St #632",
"city": "Reidsville",
"state": "NC",
"country_code": "US",
"postal_code": "273203869",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.