RANDI L. SHUPP PA-C NPI 1831183854

NPI Information

NPI: 1831183854
Provider Name: RANDI L. SHUPP, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
250 CETRONIA ROAD
SUITE 303
ALLENTOWN, PA
ZIP 18104
Phone: (610) 973-6200
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Randi L. Shupp, PA-C is a medical physician assistant in Allentown, PA. Randi L. Shupp, PA-C NPI is 1831183854. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

250 CETRONIA ROAD
SUITE 303
ALLENTOWN, PA
ZIP 18104-168
Phone: (610) 973-6200
Fax: (610) 973-6546

The NPI 1831183854 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 9/6/2005 and was last updated on 12/23/2015.

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
1	363A00000X	Physician Assistant		MA051867	PENNSYLVANIA	No
2	363AS0400X	Physician Assistant	Surgical	MA051867	PENNSYLVANIA	No
3	363AM0700X	Physician Assistant	Medical	MA051867	PENNSYLVANIA	Yes

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
1	50053681	OTHER	PENNSYLVANIA	KEYSTONE CENTRAL
2	50053681	OTHER	PENNSYLVANIA	BLUE CROSS
3	Q38521	MEDICARE UPIN	PENNSYLVANIA
4	088965	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA

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: 4/28/2024

NPI Synchronization or Removal

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