SAMANTHA SHIPP
NPI 1104531805
Nurse Practitioner - Family in Campbellsville, KY

Q: What is Samantha Shipp's NPI number?

The NPI number for Samantha Shipp is 1104531805. It was assigned to this individual provider in the NPPES registry on January 17, 2023.

Q: What is Samantha Shipp's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Shipp was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 17, 2023PECOS Enrolled

1700 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718(270) 789-5794 Get Directions Write a Review

NPPES record last updated: January 17, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Samantha Shipp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA SHIPP (NPI 1104531805) is an individual family provider in Campbellsville, Kentucky, licensed in Kentucky (3018628) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104531805

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSAMANTHA SHIPP

Location Address1700 OLD LEBANON RDCampbellsville, KY 42718-9615

Mailing Address507 Fern DrCampbellsville, KY 42718-9607

Phone(270) 789-5794

Sole ProprietorYes

Enumeration DateJanuary 17, 2023

NPPES CertifiedJanuary 17, 2023

✔ NPI 1104531805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 3018628

1700 OLD LEBANON RD, Campbellsville, KY 42718

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Shipp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Shipp reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Concord Medical Group Of Kentucky PLLC

67 mi

Emergency Medicine

1011 OLD HIGHWAY 60
Hardinsburg, KY 40143

Reassigned Medicare billing, Kentucky enrollment
182 clinicians in this Medicare group

NPI 1346746385 (270) 756-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

105 services99 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

103 services97 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

55 services53 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42718 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYED FURQAN GILANI M.B.B.S

Orthopaedic Surgery