Amy Shipp, LAT, ATC, ITAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36001373A Issued in IN

Practice address

9273 N State Road 9
Hope, IN 47246-9760

Phone

(812) 546-4421

Fax

(812) 546-2005

NPI assigned

Dec 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Pence Former name

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": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1770812216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 SAINT CHARLES WAY",
            "city": "WHITELAND",
            "state": "IN",
            "postal_code": "461841671",
            "telephone_number": "812-344-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9273 N STATE ROAD 9",
            "city": "HOPE",
            "state": "IN",
            "postal_code": "472469760",
            "telephone_number": "812-546-4421",
            "fax_number": "812-546-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "AMY",
        "credential": "LAT, ATC, ITAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-11",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001373A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "PENCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Johnson Memorial Hospital
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• Amy L Miller, D.C.
• Ryohei Otsuka, MD
• Tristan L. Schaefer, RN
• Mark Kevin Stine, M.D.
• Hideki Tsunoda, M.D.
• Windrose Health Network, Inc.
• Lynda K Ziegler, WHNP-BC

• Athletic Trainer in Hope, IN
• Providers in Hope, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.