Individual provider Active NPI

Rebekah Kay Hofstra Shappley, MD

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1639337744
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44857 Issued in TN
Practice address
1129 Hale Rd
Memphis, TN 38116-6373
Phone
(901) 396-0390
NPI assigned
May 26, 2008
Last updated
May 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44857 TN Primary

Addresses

Primary practice location

1129 Hale Rd
Memphis, TN 38116-6373

Mailing address

1129 Hale Rd
Memphis, TN 38116-6373
Phone (901) 396-0390

Other names 1

  • Dr. Rebekah Kay Hofstra Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302002092 TN Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 9032355680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pediatric Medicine
Education
Columbia University College of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

51 N Dunlap St
Memphis, TN 38105-4625
Phone (901) 287-7337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatrics CurrentSince Apr 1, 2016 Accepting new patients

Locations

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: rshappley32456@mlh.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1639337744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 HALE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166373",
            "telephone_number": "901-396-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 HALE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166373",
            "telephone_number": "901-396-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPPLEY",
        "first_name": "REBEKAH",
        "middle_name": "KAY HOFSTRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "44857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "HOFSTRA",
            "middle_name": "KAY",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.