NPIMap

Individual provider Active NPI

Shersten Killip, MD

  • Family Medicine Physician
  • Florence, MA
National Provider Identifier
1912933128
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
238794 Issued in MA
Practice address
70 Main St
Florence, MA 01062-1466
Phone
(413) 586-8400
Fax
(413) 585-5435
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36841 KY
Family Medicine Physician 207Q00000X 238794 MA Primary

Addresses

Primary practice location

70 Main St
Florence, MA 01062-1466

Mailing address

70 Main St
Florence, MA 01062-1466
Phone (413) 586-8400

Other identifiers 2

IdentifierTypeStateIssuer
110082604AMedicaidMA
64038961MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090813000635 MA Practitioner - Family Practice 4284788035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group PCGroup PAC ID 2365348851, 106 clinicians

Practice addresses (Care Compare)

70 Main St
Florence, MA 01062-1466
Phone (413) 586-8400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36841KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group, P.C. CurrentSince Aug 3, 2009 Accepting new patients
Valley Medical Group, P.C. Family Medicine CurrentSince Aug 3, 2009 Accepting new patients
Valley Medical Group, P.C. Past Accepting new patients

Locations

70 Main St
Northampton, MA 01062
Phone (413) 586-8400

Interoperability endpoints

  • Direct secure messaging: shersten.killip.1@55.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1912933128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621466",
            "telephone_number": "413-586-8400",
            "fax_number": "413-585-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621466",
            "telephone_number": "413-586-8400",
            "fax_number": "413-585-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIP",
        "first_name": "SHERSTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "36841",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "238794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082604A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64038961",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, MA

Sources for this page

Verify at the official NPI Registry.