Samara Shipon, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

005412 Issued in AZ

Practice address

1850 N Central Ave
Suite 1600
Phoenix, AZ 85004-4527

Phone

(602) 744-4765

Fax

(602) 744-4799

NPI assigned

Feb 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1487893152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E MISSOURI AVE",
            "address_2": "STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121351",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE",
            "address_2": "SUITE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044527",
            "telephone_number": "602-744-4765",
            "fax_number": "602-744-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPON",
        "first_name": "SAMARA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OS014189",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "005412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549675",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia L Shipman, LCSW
• Brandon James Shipman
• Kimberly Shipman, M.D.
• Laura N Shipman
• Troy Joseph Shipman, DO
• Shirah Surgical PLLC
• Shannon Keenan Shirav, RMA
• Gila Heike Shire
• Lora Anna Shirey, MD
• Logan Austin Shirk, PHARMD, MBA

• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.

Verify at the official NPI Registry.