Timothy Shipp, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-500 Issued in AR

Practice address

101 MSGT Dan Wassom Road
Little Rock AFB, AR 72099-0001

Phone

(501) 987-6951

NPI assigned

Nov 8, 2012

Last updated

Jul 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1417024662
  Medicare reassignment NPD
• Faulkner Emergency Group, PLLC

  • Emergency Medicine Physician
  • Conway, AR
  • NPI 1083279533
  Medicare reassignment
• Forrest City Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Forrest City, AR
  • NPI 1497080501
  Medicare reassignment
• Shiloh Emergency Group PLLC

  • Emergency Medicine Physician
  • Sherwood, AR
  • NPI 1205458189
  Medicare reassignment
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1922475078
  Medicare reassignment
• St. Vincent Infirmary Medical Center

  dba St Vincent North Anesthesia Group

  • Certified Registered Nurse Anesthetist
  • Sherwood, AR
  • NPI 1316991847
  Medicare reassignment
• Conway Regional Medical Center Inc

  dba Conway Regional Mobile Health Unit

  • Family Medicine Physician
  • Conway, AR
  • NPI 1043183544
  NPD
• Forrest City Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1760897904

  Physician Assistant

  NPD
• South Arkansas Pathology, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pine Bluff, AR
  • NPI 1376590083
  NPD
• Southeast Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • Pine Bluff, AR
  • NPI 1467817411
  NPD
• St Vincent Infirmary Medical Center

  dba St Vincent Infirmary Medical Center - GeroPsych Unit

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1710442801
  NPD
• St. Vincent Infirmary Medical Center

  • Emergency Medicine Physician
  • Sherwood, AR
  • NPI 1134513906
  NPD

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1780938951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MSGT DAN WASSOM ROAD",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720990001",
            "telephone_number": "501-987-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MSGT DAN WASSOM ROAD",
            "city": "LITTLE ROCK AFB",
            "state": "AR",
            "postal_code": "720990001",
            "telephone_number": "501-987-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPP",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-08",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Lynnette Roth, PHARM.D.
• Joshua Routt, LCSW
• Jeff J. Sandoval, IDMT
• Kristie R Sandusky, IDMT
• Samuel Schmidt, PA-C
• Susan Bratcher Smith, LCSW, ICAADC
• Yoohyun Song
• Timothy Ryan Southerland, PHD
• Anna R. Stanton
• Sunland Optical Co., Inc.

• Physician Assistant in Little Rock AFB, AR
• Providers in Little Rock AFB, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.