SHELTANA MICHELLE HIPPS (NPI# 1164925863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164925863 |
| Entity Type | Individual |
| Full Name | SHELTANA MICHELLE HIPPS |
| Credential | NP |
| Practice Address |
2435 Forest Dr Columbia SC 29204-2026 |
| Mailing Address |
1655 Bernardin Ave Ste 220 Columbia SC 29204-2044 |
| Practice Telephone | 8034097170 |
| Practice Fax Number | 8034097175 |
| Mailing Telephone | 8034097170 |
| Mailing Fax Number | 8034097175 |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
21620 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICAL LICENSE | 21620 | 01 |
| Street Address |
2435 FOREST DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811290 | Providence Hospital, LLC | General Acute Care Hospital | 2435 Forest Dr, Columbia, SC 29204-2026 | 2005-06-15 |
| 1184271223 | Taylor Trull | Physician Assistant | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-08-22 |
| 1336794262 | Jillian Janss | Physical Therapist | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-08-07 |
| 1962063115 | Meagan Kirkley Wall | Nurse Anesthetist, Certified Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-06-27 |
| 1003376757 | Abigail Gottshall | Dietitian, Registered | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-03-20 |
| 1053875120 | Smita Patel | Specialist/Technologist, Other | 2435 Forest Dr, Columbia, SC 29204-2026 | 2019-01-23 |
| 1538662556 | Prunetta Brunson | Nurse Practitioner | 2435 Forest Dr, Columbia, SC 29204-2026 | 2018-03-15 |
| 1154841021 | Broad River Physicians Group, LLC | Emergency Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2017-06-22 |
| 1659818599 | Providence Professional Services LLC | Emergency Medicine | 2435 Forest Dr, Columbia, SC 29204-2026 | 2017-01-30 |
| 1427418318 | Providence Hospital LLC | Physical Therapist | 2435 Forest Dr, Columbia, SC 29204-2026 | 2016-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043671134 | Abbey Tapler | Nurse Practitioner | 9 Richland Med Pk Dr Ste 450, Columbia, SC 29203-6859 | 2016-03-16 |
| 1528428448 | Mary Frances Snipes | Nurse Practitioner | 3 Richland Medical Park Dr., Suite 310, Columbia, SC 29203-6862 | 2016-03-04 |
| 1841659216 | Lindsey Culbertson Cossio | Nurse Practitioner | 121park Central Drive, Suite 200, Columbia, SC 29203-6476 | 2016-02-15 |
| 1386987634 | Megan L Stanfill | Nurse Practitioner | 915 S Garden St, Columbia, TN 38401 | 2013-04-04 |
| 1699015347 | Farahnaz Nafisy | Nurse Practitioner | 3010 Farrow Rd Ste 300, Columbia, SC 29203-7606 | 2013-02-17 |
| 1114270030 | Rhonda Lamar Gibson | Nurse Practitioner | 147 Fox Squirrel Cir, Columbia, SC 29209-4478 | 2012-10-16 |
| 1952675043 | Charissa Kirkland Lowe | Nurse Practitioner | 1614 Main Street Suite C, Ltc Health Solutions, Columbia, SC 29201-2818 | 2012-03-07 |
| 1467741108 | Ashley L Chapman | Nurse Practitioner | 121 Park Central Dr Ste 200, Columbia, SC 29203-6476 | 2011-04-04 |
| 1629001508 | Carrie A Miller | Nurse Practitioner | 706 Ames Dr, Columbia, MO 65201-7571 | 2006-07-07 |
| 1275591687 | Beckie Merritt Church | Nurse Practitioner | 8 Medical Park Rd, Suite 300, Columbia, SC 29203-6864 | 2006-05-03 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.