NPIMap

Individual provider Active NPI

Emily Nicole Shipley, MOTR/L

  • Occupational Therapist
  • Charlotte Hall, MD
National Provider Identifier
1164576823
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
05697 Issued in MD
Practice address
29770 Three Notch Road
Charlotte Hall, MD 20622
Phone
(301) 290-0800
Fax
(301) 290-1313
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6179 NC
Occupational Therapist 225X00000X 05697 MD Primary

Addresses

Primary practice location

29770 Three Notch Road
Charlotte Hall, MD 20622

Mailing address

10535 Welch Family Farm Place
Charlotte Hall, MD 20622
Phone (301) 290-0800

Other names 1

  • Ms. Emily Nicole Elgin Former name

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
05697MDMDClinical Psychologist
6179NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1164576823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 WELCH FAMILY FARM PLACE",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "20622",
            "telephone_number": "301-290-0800",
            "fax_number": "301-290-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29770 THREE NOTCH ROAD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "20622",
            "telephone_number": "301-290-0800",
            "fax_number": "301-290-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "EMILY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "6179",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "05697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ELGIN",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.