Individual provider Active NPI

William Albert Shope

  • Addiction (Substance Use Disorder) Counselor
  • Woodruff, WI
National Provider Identifier
1508675968
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20740130 Issued in WI
Practice address
9198A Thrall Rd
Woodruff, WI 54568-9329
Phone
(715) 439-4377
NPI assigned
Dec 31, 2024
Sex
Male
Sole proprietor
Yes

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
20740130WIMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20740130 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

9198A Thrall Rd
Woodruff, WI 54568-9329

Mailing address

12308 E Fitzgerald LN
Manitowish Waters, WI 54545-9249
Phone (715) 904-0869

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 31, 2024.

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1508675968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12308 E FITZGERALD LN",
            "city": "MANITOWISH WATERS",
            "state": "WI",
            "postal_code": "545459249",
            "telephone_number": "715-904-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9198A THRALL RD",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545689329",
            "telephone_number": "715-439-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOPE",
        "first_name": "WILLIAM",
        "middle_name": "ALBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20740130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodruff, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.