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JOHNNY R SHUPE APRN NPI 1659495356


NPI Information

NPI: 1659495356
Provider Name: JOHNNY R SHUPE, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
373 CECIL D QUILLEN DR
SUITE 101
DUFFIELD, VA
ZIP 24244
Phone: (276) 431-1638
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Johnny R Shupe, APRN is a family nurse practitioner in Duffield, VA with 31 years of experience. Johnny R Shupe, APRN NPI is 1659495356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:1993

The provider's business location address is:

373 CECIL D QUILLEN DR
SUITE 101
DUFFIELD, VA
ZIP 24244-085
Phone: (276) 431-1638
Fax: (276) 431-1639

The NPI 1659495356 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 8/12/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily0024151769VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C08199MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAGRP. PROVIDER NUMBER
2003218R99MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAIND. PROVIDER NUMBER
3007790741MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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