Cody W Shipley, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704355672 Issued in MI

Practice address

818 Paris Ave NE
Grand Rapids, MI 49503-1753

Phone

(214) 728-5982

NPI assigned

Mar 4, 2025

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 MI

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Supportive Care I of Michigan PCGroup PAC ID 9638554298, 19 clinicians

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Supportive Care I of Michigan PC

  • Clinical Psychologist
  • Iron River, MI
  • NPI 1548995608

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130
  NPD

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1962200360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 PARIS AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031753",
            "telephone_number": "214-728-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 PARIS AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031753",
            "telephone_number": "214-728-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "CODY",
        "middle_name": "W",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704355672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Shimp, COTA/L
• Andrew J. Shin, MD
• Minnie Shinal
• Shine Therapy PLLC
• Olivia Shinrock
• Lauren Shipman, MOT
• Kamisha Shipp
• Brian Shipton, D.D.S
• Brooke Marianna Shirley
• Laura Rae Shirley, CNP

• Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.
• 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.

Verify at the official NPI Registry.