Individual provider Active NPI

Julie Ann Shuptrine, L.I.S.W.

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1043316722
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0007848 Issued in OH
Practice address
52 W 5TH Ave
Ste a
Columbus, OH 43201-7200
Phone
(614) 578-9644
Fax
(614) 358-1122
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0007848 OH Primary

Addresses

Primary practice location

52 W 5TH Ave
Ste a
Columbus, OH 43201-7200

Mailing address

3171 E Broad St
Columbus, OH 43209-2056
Phone (614) 578-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0007848OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1043316722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3171 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432092056",
            "telephone_number": "614-578-9644",
            "fax_number": "614-358-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W 5TH AVE",
            "address_2": "STE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432017200",
            "telephone_number": "614-578-9644",
            "fax_number": "614-358-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPTRINE",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0007848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.