Wade Paul Shipley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

252 Issued in MT

Practice address

6 13TH Ave E
Polson, MT 59860

Phone

(406) 883-5680

Fax

(406) 883-8910

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

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

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence St Joseph Medical CenterGroup PAC ID 0446230247, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Joseph Medical Center Hospital, Polson, MT, CCN 271343

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wshipley236294@wm.providencedirect.org

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.

• Providence St Joseph Medical Center

  • Family Medicine Physician
  • Polson, MT
  • NPI 1669655528
  Medicare reassignment Care Compare group
• Providence Health & Services Mt

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment
• Providence Health & Services Mt

  • Pediatrics Physician
  • Missoula, MT
  • NPI 1154562981
  NPD
• Providence Health & Services Mt

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD

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

• Providence St Joseph Medical Center

  • Critical Access Hospital
  • Polson, MT
  • NPI 1821184888
  Care Compare affiliation

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1962531913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "59860",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "WADE",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wshipley236294@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "5 4th Ave E",
            "city": "Polson",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598602117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric M Schallock, PA
• David Harold Schwartz
• Hemlata Shah
• Stephen Andrew Shepro, PA-C
• Thomas E Sherry, M.D.
• Kyota Shizuku, PT
• Elizabeth Ann Sidebottom, RPH
• Gayle R. Siemers, D.D.S.
• David J. Sievert, D.D.S.
• Wendy Sitter, PT

• Physician Assistant in Polson, MT
• Providers in Polson, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.