Individual provider Active NPI

Shawna Renee Shipman, ARNP

  • Family Nurse Practitioner
  • Cleveland, OK
National Provider Identifier
1639444532
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
76268 Issued in OK
Practice address
1400 W Pawnee St
Cleveland, OK 74020-3020
Phone
(918) 358-3588
Fax
(918) 358-2639
NPI assigned
Mar 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 76268 OK Primary

Addresses

Primary practice location

1400 W Pawnee St
Cleveland, OK 74020-3020

Mailing address

100 N Hickerson Dr
Cleveland, OK 74020-4003
Phone (918) 358-1600

Other identifiers 1

IdentifierTypeStateIssuer
200443320AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120913000080 OK Practitioner - Nurse Practitioner 1254589450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Area Hospital AuthorityGroup PAC ID 3476615733, 6 clinicians

Practice addresses (Care Compare)

1400 W Pawnee St
Cleveland, OK 74020-3020

1401 W Pawnee St
Cleveland, OK 74020-3020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Area Hospital Holdings, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Cleveland Area Hospital Holdings, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Cleveland Area Hospital Authority Current Accepting new patients
Cleveland Area Hospital Holdings, Inc. Past Accepting new patients

Locations

1401 W Pawnee St
Cleveland, OK 74020
Phone (918) 358-2501

1400 W Pawnee St
Cleveland, OK 74020
Phone (918) 358-3588

Interoperability endpoints

  • Direct secure messaging: shawna.shipman.1@13140.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1639444532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HICKERSON DR",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740204003",
            "telephone_number": "918-358-1600",
            "fax_number": "918-358-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W PAWNEE ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203020",
            "telephone_number": "918-358-3588",
            "fax_number": "918-358-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPMAN",
        "first_name": "SHAWNA",
        "middle_name": "RENEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "76268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200443320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OK

Sources for this page

Verify at the official NPI Registry.