Jaime Shoup, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

57923 Issued in KY

Practice address

2933 Breckenridge LN Ste 101
Louisville, KY 40220-1494

Phone

(502) 588-0736

Fax

(502) 588-0721

NPI assigned

Apr 23, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshoup103134@direct.nortonhealthcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  IN

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Louisville, KY
  • NPI 1134760796
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Gastroenterology Physician
  • Louisville, KY
  • NPI 1518508167
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Commission for Children With Special Health Car

  • Public Health or Welfare Agency
  • Louisville, KY
  • NPI 1831197953
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1023543535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 BRECKENRIDGE LN STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201494",
            "telephone_number": "502-588-0736",
            "fax_number": "502-588-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021713",
            "country_code": "US",
            "telephone_number": "502-588-0850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "JAIME",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-23",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "KY",
            "license": "57923",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IN",
            "license": "01093584A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "57923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Short
• Rebecca Hope Short, LCSW
• David L Shorten, D.M.D.
• Steven D Shotts, MD
• Elisabeth Shoulders, MS, ATC
• Sherry Shouse
• Winifred Ann Shouse, APRN, FNP-C
• Jane Ellen Shown, P.T.
• Johnna C Shown, APRN, FNP-C
• Hallie Lyninger Shpack, MS

• Neurology with Special Qualifications in Child Neurology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.