NPIMap

Individual provider Active NPI

Alexa Shipp, APRN

  • Acute Care Nurse Practitioner
  • Conway, AR
National Provider Identifier
1659868933
Registry record updated Apr 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A005530 Issued in AR
Practice address
525 Western Ave Ste 202
Conway, AR 72034-4980
Phone
(501) 358-6905
NPI assigned
Apr 22, 2018
Last updated
Apr 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A005530 AR Primary

Addresses

Primary practice location

525 Western Ave Ste 202
Conway, AR 72034-4980

Mailing address

5 Brandon Cir
Conway, AR 72034-7503
Phone (870) 378-0061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018002857 AR Practitioner - Nurse Practitioner 0749533867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Regional Medical Center IncGroup PAC ID 3173428414, shared by 26 NPIs, 129 clinicians

Practice addresses (Care Compare)

525 Western Ave
Suite 202
Conway, AR 72034-4980
Phone (501) 358-6905

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Aug 15, 2018 Accepting new patients
Conway Regional Medical Center, Inc. CurrentSince Jan 29, 2024 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Aug 15, 2018 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

525 Western Ave
Ste 2
Conway, AR 72034
Phone (501) 358-6905

525 Western Ave
Ste 202
Conway, AR 72034
Phone (501) 358-6905

525 Western Ave
Ste 301
Conway, AR 72034
Phone (501) 513-5295

525 Western Ave
Ste 302
Conway, AR 72034
Phone (501) 328-5515

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1524355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524355200000",
    "number": "1659868933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRANDON CIR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347503",
            "telephone_number": "870-378-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE STE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344980",
            "telephone_number": "501-358-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "ALEXA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-22",
        "last_updated": "2018-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A005530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.