Individual provider Active NPI

Philip Stephen Shirey, RN NP

  • Obstetrics & Gynecology Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1982750253
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
RN247365 Issued in CA
Practice address
651 Wake Ave
Ste. 4
El Centro, CA 92243-9490
Phone
(760) 352-2257
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN247365 CA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN247365 CA Primary

Addresses

Primary practice location

651 Wake Ave
Ste. 4
El Centro, CA 92243-9490

Mailing address

1166 K St
Brawley, CA 92227-2737
Phone (760) 344-9951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN247365CAMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1982750253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 K ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272737",
            "telephone_number": "760-344-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 WAKE AVE",
            "address_2": "STE. 4",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439490",
            "telephone_number": "760-352-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIREY",
        "first_name": "PHILIP",
        "middle_name": "STEPHEN",
        "credential": "RN NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "RN247365",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "RN247365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.