NPIMap

Individual provider Active NPI

Kimberly Alice Shipley, DNP/FNP; ARNP

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1083128524
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60777569 Issued in WA
Practice address
409 S 12TH Ave
Yakima, WA 98902-3114
Phone
(509) 575-2949
Fax
(509) 575-5743
NPI assigned
Nov 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X AP60777569 WA
Family Nurse Practitioner 363LF0000X AP60777569 WA Primary

Addresses

Primary practice location

409 S 12TH Ave
Yakima, WA 98902-3114

Mailing address

PO Box 2069
Selah, WA 98942-0015
Phone (509) 480-9317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190215001851 WA Practitioner - Nurse Practitioner 9537407556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thuthi Enterprises LLCGroup PAC ID 3870903099, 7 clinicians

Practice addresses (Care Compare)

715 N Park Ctr
Suite a
Selah, WA 98942-1174
Phone (509) 698-2624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.73 of 100Reported as group
Quality
80.23
Promoting interoperability
82
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60777569WAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thuthi Enterprises, LLC CurrentSince Oct 1, 2023 Accepting new patients
Thuthi Enterprises, LLC PastSince Jul 27, 2020 Accepting new patients

Locations

715 North Park Ctr
#B
Selah, WA 98942
Phone (509) 248-0497

715 North Park Ctr
Ste B
Selah, WA 98942
Phone (509) 426-2378

715 North Park Ctr
Ste A
Selah, WA 98942
Phone (509) 426-2378

Interoperability endpoints

  • Direct secure messaging: kimberly.shipley.1@22275.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/22275/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1083128524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2069",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989420015",
            "telephone_number": "509-480-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 S 12TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023114",
            "telephone_number": "509-575-2949",
            "fax_number": "509-575-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "KIMBERLY",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "DNP/FNP; ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WA",
            "license": "AP60777569",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60777569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.