Individual provider Active NPI

Kristina Jane Shipman, OT

  • Occupational Therapist
  • Clermont, FL
National Provider Identifier
1598978116
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 9855 Issued in FL
Practice address
2400 S Hwy 27
Clermont, FL 34711-6816
Phone
(352) 394-0212
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 9855 FL Primary

Addresses

Primary practice location

2400 S Hwy 27
Clermont, FL 34711-6816

Mailing address

2400 S Hwy 27
Clermont, FL 34711-6816
Phone (352) 394-0212

Other identifiers 1

IdentifierTypeStateIssuer
887909500MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170821001097 FL Practitioner - Occupational Therapist in Private Practice 1153693585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 9855FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Apr 1, 2023 Accepting new patients
Lampert's Home Therapy, Inc. Occupational Therapist CurrentSince Jun 3, 2017 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Nov 19, 2024 Accepting new patients
Legacy Healthcare Services, Inc Occupational Therapist CurrentSince Apr 1, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Nov 19, 2024 Accepting new patients
Central Florida Dreamplex LLC PastSince Feb 1, 2022 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8254 118th Ave
Ste 100
Largo, FL 33773
Phone (727) 451-5304

9101 SW 24th St
Miami, FL 33165
Phone (305) 330-6698

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 6

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1598978116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S HWY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116816",
            "telephone_number": "352-394-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S HWY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116816",
            "telephone_number": "352-394-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "KRISTINA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 9855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887909500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.