DR. SHINPEI SHIBATA (NPI# 1609179639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609179639 |
| Entity Type | Individual |
| Full Name | DR. SHINPEI SHIBATA |
| Credential | M.D. |
| Practice Address |
707 Sw Gaines St Mail Code: Cdrcp Portland OR 97239-2901 |
| Mailing Address |
1200 Nw Marshall St Ste 4340 Portland OR 97209-3165 |
| Practice Telephone | 5034941544 |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2011-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
154527 | OR | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
21500017 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
707 SW GAINES ST MAIL CODE: CDRCP |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184613960 | Laurie Armsby | Pediatrics | 707 Sw Gaines St, Cdrc-p, Portland, OR 97239-2901 | 2005-10-14 |
| 1851904759 | Debra Crawford | Physical Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-28 |
| 1437761574 | Lauren Nicole Beckett | Speech-Language Pathologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-19 |
| 1720699739 | Rachel Kirsten Greene | Psychologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-13 |
| 1356970008 | Emily Knell Spaeth | Physical Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-04-05 |
| 1720617798 | Paula Tran | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-04-02 |
| 1760038111 | Natalie Alexandra Galvan | Speech-Language Pathologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-08-12 |
| 1932752466 | Janvi S. Patel | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-07-23 |
| 1033761119 | Danielle Moyer | Psychologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-07-10 |
| 1790268779 | Lily Gullion | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2018-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093294654 | Elva Linda Pereida | Pediatrics | 107 Palisades, Portland, TX 78374-4144 | 2018-08-14 |
| 1699066647 | Michael Zubrow | Pediatrics | 22 Bramhall St, Portland, ME 04102 | 2011-04-26 |
| 1487953154 | Laura Amar-dolan | Pediatrics | 22 Bramhall St, Portland, ME 04102-3175 | 2011-03-21 |
| 1437303443 | Cydni Nicole Williams | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-11-05 |
| 1083863682 | Pediatric Intensive Care Trauma Associates PC | Pediatrics | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2008-09-18 |
| 1891976098 | Kristine M Pleacher | Pediatrics | 22 Bramhall St, Portland, ME 04102 | 2007-11-16 |
| 1861607434 | Amit Mehta | Pediatrics | 707 Sw Gaines St, Cdrc-p, Portland, OR 97239-2901 | 2007-05-14 |
| 1972649283 | Carolyn F Shelak | Pediatrics | 2801 N Gantenbein Ave, Legacy Emanuel Children's Hospital, Portland, OR 97227-1623 | 2007-01-30 |
| 1780692210 | Miles Steven Ellenby | Pediatrics | 3181 Sw Sam Jackson Park Rd, Doernbecher Children's Hospital Pediatric Icu, Portland, OR 97239-3011 | 2006-08-03 |
| 1780699298 | Aileen Lanette Kirby | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-07-31 |
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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.