Individual provider Active NPI

Amelia Shillingford, NP

  • Women's Health Nurse Practitioner
  • Millbrook, NY
National Provider Identifier
1164711834
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
F421027-1 Issued in NY
Practice address
165 Canoe Hill Rd
Millbrook, NY 12545-6522
Phone
(202) 557-0576
NPI assigned
Apr 4, 2011
Last updated
Apr 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X F421027-1 NY Primary

Addresses

Primary practice location

165 Canoe Hill Rd
Millbrook, NY 12545-6522

Mailing address

165 Canoe Hill Rd
Millbrook, NY 12545-6522
Phone (202) 557-0576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20111128000535 VT Practitioner - Nurse Practitioner 9032383211 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F421027-1NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Retreat CurrentSince Nov 7, 2016 Accepting new patients
Brattleboro Retreat Past Accepting new patients

Locations

1 Anna Marsh Ln
Dummerston, VT 05301

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1164711834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CANOE HILL RD",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125456522",
            "telephone_number": "202-557-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CANOE HILL RD",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125456522",
            "telephone_number": "202-557-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLINGFORD",
        "first_name": "AMELIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F421027-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrook, NY

Sources for this page

Verify at the official NPI Registry.