Samantha Shipp

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3018628 Issued in KY

Practice address

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615

Phone

(270) 789-5794

NPI assigned

Jan 17, 2023

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

• Concord Medical Group of Kentucky PLLC

  • Emergency Medicine Physician
  • Hardinsburg, KY
  • NPI 1346746385
  Medicare reassignment

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1104531805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 FERN DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-789-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3018628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaw Family Chiropractic PLLC
• Stephen Walter Shaw, DC
• Whitney Lynn Shepard, M.D.
• Amanda Rose Shepperd, APRN
• Linda K Shipp, RPH
• Eugene Herman Shively, M.D.
• Laree Shively, APRN
• Susan Ashley Shively, CRNFA, MSN, FNP-C
• Gail Shofner
• Lyndsie Short, ATC

• Family Nurse Practitioner in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.