Toshiva Deshane Shippy, FNP is a medicare enrolled "Nurse Practitioner - Family" in Woodruff, South Carolina. Her current practice location is
220 Irby St, Woodruff, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(864) 582-2411.
Toshiva Deshane Shippy is licensed to practice in South Carolina (license number 25915) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1902540172.
Provider's Profile
| Full Name | Toshiva Deshane Shippy |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 220 Irby St, Woodruff, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1902540172
- Provider Enumeration Date: 04/25/2022
- Last Update Date: 06/01/2026
Medicare PECOS Information:
- PECOS PAC ID: 4183001084
- Enrollment ID: I20220516000707
Medical Identifiers
Medical identifiers for Toshiva Deshane Shippy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902540172 | NPI | - | NPPES |
| NP9529 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 25915 (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Toshiva Deshane Shippy allows following entities to bill medicare on her behalf.
| Entity Name | Carolinas Center For Advanced Management Of Pain Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750304002
PECOS PAC ID: 4880593771
Enrollment ID: O20040108000894 |
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| Entity Name | Commonwealth Pain Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306280177
PECOS PAC ID: 0941441919
Enrollment ID: O20250114003107 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Toshiva Deshane Shippy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Toshiva Deshane Shippy, FNP
Po Box 5158,
Spartanburg, SC 29304-5158
Ph: (864) 582-2411 | Toshiva Deshane Shippy, FNP
220 Irby St,
Woodruff, SC 29388-1618
Ph: (864) 582-2411 |
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