Individual provider Active NPI

Christopher R Shupe, LCSW

  • Clinical Social Worker
  • Rolla, MO
National Provider Identifier
1457088940
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2024034052 Issued in MO
Practice address
103 W 10TH St
Rolla, MO 65401-3247
Phone
(315) 955-2823
NPI assigned
Aug 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2022029271 MO
Clinical Social Worker 1041C0700X 2024034052 MO Primary

Addresses

Primary practice location

103 W 10TH St
Rolla, MO 65401-3247

Mailing address

103 W 10TH St
Rolla, MO 65401-3247
Phone (315) 955-2823

Other practice location 1

704 Route 66 W Ste 101
Waynesville, MO 65583-8322
Phone (315) 955-2823

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL chris.shupe@hopeconnections.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910002521 MO Practitioner - Clinical Social Worker 2567902158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Connections, LLCGroup PAC ID 6507250677, 9 clinicians

Practice addresses (Care Compare)

103 W 10TH St
Rolla, MO 65401-3247
Phone (573) 433-4846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022029271MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Connections, LLC CurrentSince Aug 21, 2024 Accepting new patients

Locations

103 W 10th St
Rolla, MO 65401
Phone (573) 433-4846

704 Route 66 W
Ste 101
Waynesville, MO 65583
Phone (573) 433-4846

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1457088940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013247",
            "telephone_number": "315-955-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013247",
            "telephone_number": "315-955-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 Route 66 W Ste 101",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "MO",
            "postal_code": "655838322",
            "country_code": "US",
            "telephone_number": "315-955-2823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2022029271",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024034052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "chris.shupe@hopeconnections.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "103 W 10th St",
            "city": "Rolla",
            "state": "MO",
            "country_code": "US",
            "postal_code": "654013247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.