Amy Jo Shuptrine, MSN, APRN, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP140582 Issued in TX

Practice address

2000 S Palestine St
Athens, TX 75751-5610

Phone

(903) 676-1000

NPI assigned

Feb 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• White Rock Medical Center Hospital, Dallas, TX, CCN 450678

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.shuptrine.1@30777.direct.athenahealth.com

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.

• Pallicare, Inc

  • Community Health Nurse Practitioner
  • Texarkana, TX
  • NPI 1316511884

  TX

  Medicare reassignment Care Compare group
• Texas Spine and Joint Hospital, LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1942292255

  TX

  Medicare reassignment NPD
• Total Point - Desoto LLC

  • Family Medicine Physician
  • Lindale, TX
  • NPI 1104590330

  TX

  Medicare reassignment NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465

  Nurse Practitioner, TX

  Medicare reassignment NPD
• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084

  Nurse Practitioner, TX

  Medicare reassignment NPD
• MDS Texas Medical PLLC

  • Family Medicine Physician
  • Granbury, TX
  • NPI 1093608929

  TX

  Medicare reassignment
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966

  Nurse Practitioner

  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)
• Vital Signs Pediatrics PLLC

  • Urgent Care Clinic/Center
  • Tyler, TX
  • NPI 1073218780
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pipeline East Dallas LLC

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1801625934

  Hospital

  Care Compare affiliation
• Pipeline East Dallas, LLC

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1083112023

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1104382597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14280 STATE HIGHWAY 155",
            "city": "FRANKSTON",
            "state": "TX",
            "postal_code": "757636734",
            "telephone_number": "903-574-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757515610",
            "telephone_number": "903-676-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPTRINE",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "812655",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP140582",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140582",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP140582",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DRIVERS LICENSE",
            "identifier": "15390359",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Syed Asif Shah, MD
• J Elaine Shaw, MD
• Madison Leigh Sheets, PHARMD
• Melissa L Sheldon, FNP-C
• Halsey Taylor Shults, PHARMD, RPH
• Tifani Poskey Shuttlesworth, D.D.S.
• Tyler Scott Simpson
• Briana Jan Singleton, M.S.,CCC/SLP
• Lola Lewis Sirles
• Grant Steven Sisson, LPC

• All providers in Athens, TX
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.