MEDICARE: NATALIE RENEE SHIPLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	60966	KY

General Provider Information

NPI Number	:	1861013930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE RENEE SHIPLEY MD

Provider Business Mailing Address
First Line	:	571 S FLOYD ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-3818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 DIXIE HWY STE 127
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40258-3951
Country	:	US
Telephone Number	:	502-355-6339
Fax Number	:	502-935-5706

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2020
Last Update Date	:	07/29/2025

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Directions to “ NATALIE RENEE SHIPLEY MD” Practice Location

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