Active NPI
Sonia Schupp
- Specialist
- Pinedale, WY
National Provider Identifier
1073976320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT-647
- Practice address
- 191 South Franklin
Pinedale, WY 82941 - Phone
- (307) 367-6306
- NPI assigned
- Apr 4, 2016
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | OT-647 | WY | Primary |
Addresses
Primary practice location
191 South Franklin
Pinedale, WY 82941
Mailing address
PO Box 955
Pinedale, WY 82941-0955
Phone (307) 367-3617
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-647 | WY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1073976320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 955",
"city": "PINEDALE",
"state": "WY",
"postal_code": "829410955",
"telephone_number": "307-367-3617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 SOUTH FRANKLIN",
"city": "PINEDALE",
"state": "WY",
"postal_code": "82941",
"telephone_number": "307-367-6306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUPP",
"first_name": "SONIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-04",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WY",
"license": "OT-647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinedale, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.