Shipyard Medical Center

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

NC 102817 Issued in NC

Legal business name

SHIPYARD MEDICAL CENTER

Practice address

2632 Carolina Beach Rd
Suite C
Wilmington, NC 28412-1806

Phone

(919) 931-0490

Fax

(910) 796-1177

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Betty G. Mackie

Title

Office Manager

Phone

(919) 931-0490

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609918937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 CAROLINA BEACH RD",
            "address_2": "SUITE C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121806",
            "telephone_number": "919-931-0490",
            "fax_number": "910-796-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 CAROLINA BEACH RD",
            "address_2": "SUITE C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121806",
            "telephone_number": "919-931-0490",
            "fax_number": "910-796-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIPYARD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKIE",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-931-0490"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "NC 102817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Anne Shields, CRNA
• Aimee Shin, PHARMD
• Sylvia Ji-Sun Shin, MD
• Laken Kiana Shingleton, LCSWA
• Melissa Faith Game Shipley, M.D.
• Anne Gillies Shirk, RBT
• Julia Ann Shirley, PT
• Brian Charles Shiro, MD
• Tiffany W Shivar, LCSWA
• Nadine Shivers, FNP-C

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.