Active NPI
Melody Shupe
- Clinical Social Worker
- Gallipolis, OH
National Provider Identifier
1083340723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2208418
- Practice address
- 254 Pinecrest Dr
Gallipolis, OH 45631-1347 - Phone
- (740) 578-4824
- Fax
- (740) 578-4821
- NPI assigned
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 181275 | OH | |
| Clinical Social Worker | 1041C0700X | 2208418 | OH | Primary |
Addresses
Primary practice location
254 Pinecrest Dr
Gallipolis, OH 45631-1347
Mailing address
254 Pinecrest Dr
Gallipolis, OH 45631-1347
Phone (740) 578-4824
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | smithfhc2@yahoo.com |
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 |
|---|---|---|---|
| 181275 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 2208418 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677283200000",
"number": "1083340723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-578-4824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-578-4824",
"fax_number": "740-578-4821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUPE",
"first_name": "MELODY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-26",
"last_updated": "2023-02-25",
"certification_date": "2023-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "181275",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "2208418",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "smithfhc2@yahoo.com",
"affiliation": "N",
"address_1": "254 Pinecrest Dr",
"city": "Gallipolis",
"state": "OH",
"country_code": "US",
"postal_code": "456311347",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.