Active NPI
Terry L Shipe, M.D.
- Family Medicine Physician
- Angola, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01029019A
- Practice address
- 306 E Maumee St Ste 201
Angola, IN 46703-2035 - Phone
- (260) 665-7595
- Fax
- (260) 665-6586
- NPI assigned
- May 27, 2005
- Reactivated
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01029019A | IN | Primary |
Addresses
Primary practice location
306 E Maumee St Ste 201
Angola, IN 46703-2035
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100329370A | Medicaid | IN |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tshipe11737@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkview Health System Inc | Anesthesiology | Current | Accepting new patients |
Locations
817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590
306 E Maumee St
Ste 2
Angola, IN 46703
Phone (260) 665-7595
306 E Maumee St
Ste 201
Angola, IN 46703
Phone (260) 665-7595
306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335
416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141
11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012
240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000
Interoperability endpoints
- tshipe11737@direct.parkviewexchange.com
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": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1407859994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 E MAUMEE ST STE 201",
"city": "ANGOLA",
"state": "IN",
"postal_code": "467032035",
"telephone_number": "260-665-7595",
"fax_number": "260-665-6586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPE",
"first_name": "TERRY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01029019A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100329370A",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tshipe11737@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "306 E Maumee St Ste 201",
"city": "Angola",
"state": "IN",
"country_code": "US",
"postal_code": "467032035",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "306 E Maumee St Ste 201",
"city": "Angola",
"state": "IN",
"country_code": "US",
"postal_code": "467032035",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "306 E Maumee St Ste 201",
"city": "Angola",
"state": "IN",
"country_code": "US",
"postal_code": "467032035",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Angola, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.