Active NPI
Brian W Shippert, D.O.
- Critical Care Medicine (Internal Medicine) Physician
- State College, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 036155857
- Practice address
- 1800 E Park Ave
State College, PA 16803-6709 - Phone
- (814) 278-4818
- Fax
- (814) 234-6150
- NPI assigned
- Sep 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | OS014818 | PA | |
| Emergency Medicine Physician | 207P00000X | 2010-00473 | NC | |
| Emergency Medicine Physician | 207P00000X | OS11793 | FL | |
| Emergency Medicine Physician | 207P00000X | 0102203823 | VA | |
| Emergency Medicine Physician | 207P00000X | OS014818 | PA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 036155857 | IL | Primary |
Addresses
Primary practice location
1800 E Park Ave
State College, PA 16803-6709
Mailing address
1800 E Park Ave
State College, PA 16803-6709
Phone (814) 278-4818
Other practice location 1
800 E Carpenter St
Springfield, IL 62769-6709
Phone (217) 544-6464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, FL, GA, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626
141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322
143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470
155 Wellness Way
State College, PA 16803-6702
155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7000
Hospital & facility affiliations
- Mount Nittany Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS11793 | FL | MD | Emergency Medicine Physician |
| 2010-00473 | NC | MD | Emergency Medicine Physician |
| OS014818 | PA | MD | Emergency Medicine Physician |
| 0102203823 | VA | MD | Emergency Medicine Physician |
| 036155857 | IL | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group of Pennsylvania PC | Current | Accepting new patients | |
| Northeast Georgia Physicians Group Inc | Critical Care Medicine | Current | Accepting new patients |
| SJL Health Systems Inc | Current | Accepting new patients | |
| Apogee Medical Group of Pennsylvania PC | Current | Accepting new patients | |
| HSHS Medical Group Inc | Current | Accepting new patients | |
| HSHS Medical Group Inc | Current | Accepting new patients | |
| Mount Nittany Medical Center Health Services Inc | Current | Accepting new patients | |
| Intensive Care Consortium Inc | Critical Care Medicine | Current | Accepting new patients |
| Emergency Medicine Physicians of Craven County, PLLC | Emergency Medicine | Past | Accepting new patients |
Locations
2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015
1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000
743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889
1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322
100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040
100 Hospital Ave
Ofc
Dubois, PA 15801
1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800
155 Wellness Way
State College, PA 16803
Phone (800) 367-0179
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- State College, PA
- NPI 1598992554
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1568633535
PA
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1962644807
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
Critical Care Medicine
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1649227166
-
- Rural Health Clinic/Center
- Dieterich, IL
- NPI 1033841192
-
- Skilled Nursing Facility
- Pana, IL
- NPI 1215037353
-
- Emergency Medicine Physician
- New Bern, NC
- NPI 1164462586
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- State College, PA
- NPI 1730173154
-
- Ambulatory Surgical Clinic/Center
- State College, PA
- NPI 1780750620
Hospital
-
- Ambulatory Surgical Clinic/Center
- State College, PA
- NPI 1780752378
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1801045133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 E PARK AVE",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168036709",
"telephone_number": "814-278-4818",
"fax_number": "814-234-6150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 E PARK AVE",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168036709",
"telephone_number": "814-278-4818",
"fax_number": "814-234-6150"
}
],
"practiceLocations": [
{
"address_1": "800 E Carpenter St",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "IL",
"postal_code": "627696709",
"country_code": "US",
"telephone_number": "217-544-6464",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIPPERT",
"first_name": "BRIAN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-10",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "PA",
"license": "OS014818",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2010-00473",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "OS11793",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": "0102203823",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PA",
"license": "OS014818",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IL",
"license": "036155857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.