Individual provider Active NPI

Austin Shrum, CPSS

  • Peer Specialist
  • Charlotte, NC
National Provider Identifier
1144008186
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
2023-10555-01 Issued in NC
Practice address
429 Billingsley Rd
Charlotte, NC 28211-1007
Phone
(704) 445-6900
NPI assigned
Sep 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 2023-10555-01 NC Primary

Addresses

Primary practice location

429 Billingsley Rd
Charlotte, NC 28211-1007

Mailing address

429 Billingsley Rd
Charlotte, NC 28211-1007
Phone (704) 445-6900

Other practice location 1

100 Billingsley Rd
Charlotte, NC 28211-1002
Phone (704) 376-7447

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

LicenseStateTypeSpecialty
2023-10555-01NCMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1144008186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111007",
            "telephone_number": "704-445-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111007",
            "telephone_number": "704-445-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111002",
            "country_code": "US",
            "telephone_number": "704-376-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHRUM",
        "first_name": "AUSTIN",
        "credential": "CPSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "2023-10555-01",
            "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 Sep 20, 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.

Verify at the official NPI Registry.