Martha Shuping MD

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

32172 Issued in NC

Legal business name

MARTHA SHUPING MD

Practice address

2839 Maplewood Ave
Suite a
Winston-Salem, NC 27103-4114

Phone

(336) 745-7344

Fax

(336) 768-1857

NPI assigned

Jul 29, 2015

Organization subpart

No

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

Authorized official

Name

Paula Whitley

Title

Credentialing Manager

Phone

(704) 699-8042

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1639554819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25062",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271145062",
            "telephone_number": "336-745-7344",
            "fax_number": "336-768-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 MAPLEWOOD AVE",
            "address_2": "SUITE A",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034114",
            "telephone_number": "336-745-7344",
            "fax_number": "336-768-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA SHUPING MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "WHITLEY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "704-699-8042"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "32172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902384",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Marshall
• Deja Monique Marshall
• Lauren Danielle Marshall, PHARMD
• Sarah Marshall
• Shakira Marshall
• Katy Martin-Fernandez, PHD
• Anna P Martin
• Autumn Martin, LCMHC-A
• Cara Dawn Martin, FNP-C
• Charity A. Martin, PA-C

• Adult Mental Health Clinic/Center in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.