Kimberly Woods Shipper, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA04565 Issued in TX

Practice address

100 Memorial Drive
Huntsville, TX 77340

Phone

(936) 291-4589

NPI assigned

Nov 25, 2005

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 identifiers 1

Other names 1

• Kimberly D Woods Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.shipper.1@22902.direct.athenahealth.com

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.

• Traditions Emergency Medicine PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • College Station, TX
  • NPI 1396786232
  NPD (past)
• Woodlands Emergency Physicians, LLP

  • Emergency Medicine Physician
  • The Woodlands, TX
  • NPI 1245265537
  NPD (past)

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1922081744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9072",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773400018",
            "telephone_number": "936-348-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEMORIAL DRIVE",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "77340",
            "telephone_number": "936-291-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPPER",
        "first_name": "KIMBERLY",
        "middle_name": "WOODS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICEN",
            "identifier": "PA04565",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WOODS",
            "middle_name": "D",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sally Shaver
• Samantha Marie Sheppard, MS, SLP- CF
• Sheri C Gaines MD PA
• Trisha Gail Sheridan, WHNP-BC
• Linda Carol Sherwood, NURSE AIDE
• Stacey James Shirley, R.PH.
• Cecil Rosco Shrewsberry IV, D.D.S., M.D.
• Urmil R Shukla, MD
• Iyad Shurrab
• Silver Oaks Senior Activity Center

• Medical Physician Assistant in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.