Individual provider Active NPI

Shyanne Roselynn Shipp, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Durant, OK
National Provider Identifier
1265709794
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
92357 Issued in OK
Practice address
1706 Delivery LN
Durant, OK 74701-2292
Phone
(580) 745-5228
Fax
(580) 920-9976
NPI assigned
Nov 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 92357 OK Primary
Lactation Consultant (Registered Nurse) 163WL0100X 772299 TX

Addresses

Primary practice location

1706 Delivery LN
Durant, OK 74701-2292

Mailing address

PO Box 579
Durant, OK 74702-0579
Phone (580) 745-5228

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
92357OKMDLactation Consultant (Registered Nurse)
772299TXMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Kinion E. Whittington, DO Apc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1265709794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747020579",
            "telephone_number": "580-745-5228",
            "fax_number": "580-920-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 DELIVERY LN",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012292",
            "telephone_number": "580-745-5228",
            "fax_number": "580-920-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "SHYANNE",
        "middle_name": "ROSELYNN",
        "name_prefix": "Mrs.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OK",
            "license": "92357",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "772299",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.