Individual provider Active NPI

Peter Joseph Schupp, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1114271392
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
216289 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204
Phone
(704) 384-4000
NPI assigned
Nov 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 216289 NC Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204

Mailing address

5025 Airport Center Pkwy BLDG L
Charlotte, NC 28208-5885
Phone (704) 512-7105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130524000240 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264670686 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of North Carolina at Chapel Hill School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Oct 1, 2016 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2015 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2013 Accepting new patients
The Presbyterian Hospital CurrentSince Jan 21, 2013 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Oct 1, 2016 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 21, 2013 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Oct 1, 2016 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Nov 10, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 15, 2015 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1114271392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 AIRPORT CENTER PKWY BLDG L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085885",
            "telephone_number": "704-512-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-384-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-09",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "216289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.