Active NPI
Sallie Shipp, M.D.
- Internal Medicine Physician
- Louisville, KY
National Provider Identifier
1336190503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 36407
- Practice address
- 200 Abraham Flexner Way
Louisville, KY 40202-2877 - Phone
- (502) 569-7983
- NPI assigned
- May 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01059104A | IN | |
| Internal Medicine Physician | 207R00000X | 36407 | KY | Primary |
Addresses
Primary practice location
200 Abraham Flexner Way
Louisville, KY 40202-2877
Mailing address
5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5652
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200481820 | Medicaid | IN | |
| 000000592727 | Other | KY | ANTHEM BCBS |
| 64063894 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01059104A | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cogent Healthcare of Kentucky, PSC | Internal Medicine | 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.
-
- Internal Medicine Physician
- Lexington, KY
- NPI 1053362293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237248000000",
"number": "1336190503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5410 MARYLAND WAY",
"address_2": "SUITE 300",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275064",
"telephone_number": "615-377-5652",
"fax_number": "888-241-1404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ABRAHAM FLEXNER WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402022877",
"telephone_number": "502-569-7983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPP",
"first_name": "SALLIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-13",
"last_updated": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01059104A",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "36407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200481820",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000592727",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64063894",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.