Amber Rae Shupe, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

128463 Issued in IA

Practice address

1525 W 5TH St
Storm Lake, IA 50588-3027

Phone

(712) 213-8656

NPI assigned

Jan 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amber Rae Shupe Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Buena Vista Regional Medical CenterGroup PAC ID 3476464421, shared by 4 NPIs, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cherokee Regional Medical Center Hospital, Cherokee, IA, CCN 161362

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashupe629064@direct.unitypoint.org

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.

• Buena Vista Regional Medical Center

  • Critical Access Hospital
  • Storm Lake, IA
  • NPI 1134191653
  Medicare reassignment NPD
• Buena Vista Regional Medical Center

  • Diagnostic Radiology Physician
  • Storm Lake, IA
  • NPI 1780755728

  Psychiatric/Mental Health

  Medicare reassignment NPD
• A & M Psychiatric Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meriden, IA
  • NPI 1548122302
  NPD Authorized official
• Buena Vista Regional Medical Center

  • Community/Retail Pharmacy
  • Storm Lake, IA
  • NPI 1821154220
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Sioux Valley Memorial Hospital Association

  • Critical Access Hospital
  • Primghar, IA
  • NPI 1689640500
  Care Compare affiliation

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1457002669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 M AVE",
            "city": "MERIDEN",
            "state": "IA",
            "postal_code": "510377002",
            "telephone_number": "712-229-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883027",
            "telephone_number": "712-213-8656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4904 M Ave",
            "address_purpose": "LOCATION",
            "city": "Meriden",
            "state": "IA",
            "postal_code": "510377002",
            "country_code": "US",
            "telephone_number": "712-229-5381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "AMBER",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "128463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.officeally.com",
            "affiliation": "N",
            "endpointDescription": "Office Alley Practice Mate",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "ampsychiatricservices@gmail.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "correspondence",
            "address_1": "4904 M Ave",
            "city": "Meriden",
            "state": "IA",
            "country_code": "US",
            "postal_code": "510377002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "SHUPE",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Scott
• John Scott, DO
• Lori Jo Senne, APRN
• Rex Michael Shearer, DDS
• Lisa A Shepherd, M.D.
• Brian J Smith, DDS
• Brianna Smith, O.T.
• Erin Smith, ARNP
• Jordan Lea Jewel Sniderhan, PHARMD
• Spectra Health Care, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.