Active NPI
Michael G Shupp
- Professional Counselor
- Southport, NC
National Provider Identifier
1497425870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 13547
- Practice address
- 226 Sand Dollar LN
Southport, NC 28461-6101 - Phone
- (817) 734-9252
- NPI assigned
- Sep 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 13547 | TX | Primary |
Addresses
Primary practice location
226 Sand Dollar LN
Southport, NC 28461-6101
Mailing address
226 Sand Dollar LN
Southport, NC 28461-6101
Phone (817) 734-9252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13547 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1497425870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 SAND DOLLAR LN",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284616101",
"telephone_number": "817-734-9252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 SAND DOLLAR LN",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284616101",
"telephone_number": "817-734-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUPP",
"first_name": "MICHAEL",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-16",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "13547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.