Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cody W Shipley, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1962200360

Cody W Shipley, PMHNP-BC is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2024, 2 years ago. Practices with Supportive Care I of Michigan PC, a 19-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2025
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

818 Paris Ave NE
Grand Rapids, MI 49503-1753
Phone: (214) 728-5982
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 4704355672 (MI)

Record details

NPI number1962200360
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedMarch 4, 2025
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Supportive Care I Of Michigan Pc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Grand Rapids