Individual provider Active NPI

Joshua Shipp, MS, LMT, CMT, EP-C.

  • Clinical Exercise Physiologist
  • Long Beach, CA
National Provider Identifier
1679167183
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
License
1070508 Issued in CA
Practice address
1222 Atlantic Ave
Long Beach, CA 90813-3315
Phone
(314) 706-1579
NPI assigned
Feb 24, 2021
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 77199 CA
Clinical Exercise Physiologist 224Y00000X 1070508 CA Primary

Addresses

Primary practice location

1222 Atlantic Ave
Long Beach, CA 90813-3315

Mailing address

1222 Atlantic Ave
Long Beach, CA 90813-3315
Phone (314) 706-1579

Other practice location 1

15 Tower Hill Ct
Olivette, MO 63132-3106
Phone (314) 706-1579

Other identifiers 1

IdentifierTypeStateIssuer
15134787MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1070508CAMDClinical Exercise Physiologist
77199CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joshua Shipp, LLC Massage Therapist CurrentSince Mar 4, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1679167183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133315",
            "telephone_number": "314-706-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133315",
            "telephone_number": "314-706-1579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Tower Hill Ct",
            "address_purpose": "LOCATION",
            "city": "Olivette",
            "state": "MO",
            "postal_code": "631323106",
            "country_code": "US",
            "telephone_number": "314-706-1579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "JOSHUA",
        "credential": "MS, LMT, CMT, EP-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "77199",
            "primary": false
        },
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "CA",
            "license": "1070508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15134787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.