Active NPI
Katie Bupp
- Social Worker
- Harrisburg, PA
National Provider Identifier
1063958692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW131049
- Practice address
- 121 N Nyes Rd
Suite a
Harrisburg, PA 17112-3247 - Phone
- (717) 657-4040
- NPI assigned
- Jan 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW131049 | PA | Primary |
Addresses
Primary practice location
121 N Nyes Rd
Suite a
Harrisburg, PA 17112-3247
Mailing address
121 N Nyes Rd
Suite a
Harrisburg, PA 17112-3247
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240415000045 | PA | Order and Referring Only - Clinical Social Worker | 4789023458 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW131049 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1063958692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 N NYES RD",
"address_2": "SUITE A",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171123247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 N NYES RD",
"address_2": "SUITE A",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171123247",
"telephone_number": "717-657-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUPP",
"first_name": "KATIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-06",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW131049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.