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Lori L Shipley

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

30 Medical Park, Suite 219, Wheeling, WV 26003

PECOS Enrollment

This provider is enrolled in PECOS as LORI SHIPLEY.

Based on the most recent information from CMS, provider Lori L Shipley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1255425823
Provider Type
Individual
Full Name
Shipley, Lori L
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
10/3/2006
Last Updated
5/29/2020

Contact Information

Practice Location

30 Medical Park, Suite 219, Wheeling, WV 26003

(304) 243-7160

(304) 243-6372

Mailing Location

30 Medical Park, Suite 219, Wheeling, WV 26003

(304) 243-7160

(304) 243-6372

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1083 West Virginia
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 01083 West Virginia

Provider Identifiers

ID	Description	Issuer
ID 0081006	Description Medicaid	Issuer Unlisted Ohio

Lori L Shipley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Knight, Lindy M

Farmer, Heather N

Ohio Valley Medical Center

Cummings, Brittany Paige

Coulling, Roberta Pamela

Yocke, Madison Elizabeth

Witzberger, Lawrence W

Blowers, Benjamin D

Busby, Abby Jo

Jones, Regina A