Dallas Shipley

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

9329717-4810 Issued in UT

Practice address

201 Presidents Cir
Salt Lake City, UT 84112-9049

Phone

(605) 471-0089

NPI assigned

Aug 25, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1710590286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5059 W DUCKHORN DR",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840098144",
            "telephone_number": "605-471-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PRESIDENTS CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841129049",
            "telephone_number": "605-471-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "DALLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "9329717-4810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Elizabeth Shinn, DO
• Allison A. Shinouskis, MD
• Brian E Shiozawa, MD
• Maren Shipe, M.D.
• Brook Sharp Shipley
• Grant Shipley
• Richard Wayne Shipley, PHARM.D.
• Tiffani Shipley, LCSW
• James H. Shipman, MD
• Cory Melvin Shipp, LCSW

• Athletic Trainer in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Athletic Trainer in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.