GROVER GENE SHIPMAN MD
NPI 1104929017
Emergency Medicine in Mount Shasta, CA
About Grover Gene Shipman Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GROVER GENE SHIPMAN MD (NPI 1104929017) is an individual emergency medicine provider in Mount Shasta, California, licensed in Oregon (MD25595) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grover Gene Shipman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Grover Shipman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mount Shasta, CA 96067
- Reassigned Medicare billing, California enrollment
- 61 clinicians in this Medicare group
Yreka, CA 96097
- Reassigned Medicare billing, California enrollment
- 64 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 96067 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MOUNT SHASTA, CA 96067
MOUNT SHASTA, CA 96067
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Grover Shipman's NPI number?
The NPI number for Grover Shipman is 1104929017. It was assigned to this individual provider in the NPPES registry on September 6, 2006.
Where is Grover Shipman located?
Grover Shipman practices at 914 Pine Street, Mount Shasta, CA 96067. The listed phone number is (530) 926-6111.
What is Grover Shipman's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Grover Shipman enrolled in Medicare?
Yes. Grover Shipman is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Grover Shipman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grover Shipman reassigns Medicare benefits to 2 organizations: Mount Eddy Emergency Physicians Medical Group, Inc. (Mount Shasta, CA) and Siskiyou Hospital, Inc. (Yreka, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Grover Shipman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Grover Shipman was last updated on July 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Grover Gene Shipman, MD · NPI 1104929017
Emergency Medicine physician in Mount Shasta, California. Individual provider, active in the CMS NPPES registry since September 6, 2006.
## Identity
- **NPI:** 1104929017 (Entity type: Individual)
- **Enumerated:** September 6, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** MD25595 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 914 PINE STREET, Mount Shasta, CA 96067-2143
- **Phone:** (530) 926-6111
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Mount Eddy Emergency Physicians Medical Group, Inc. (NPI 1316299787, Mount Shasta, CA); Siskiyou Hospital, Inc. (NPI 1093892275, Yreka, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 2, 2008
- **Other identifiers:** Medicaid 00A967380 (CA); Medicare UPIN I64168 (CA); Medicare PIN 00A967380 (CA); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1104929017) · Data from the CMS NPPES public registry.