Individual provider Active NPI

Shilpa Boppana, PHD

  • Clinical Psychologist
  • Vestavia Hills, AL
National Provider Identifier
1700514908
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2257 Issued in AL
Practice address
2505 Crossgate PL
Vestavia Hills, AL 35216-3116
Phone
(205) 478-7176
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2257 AL Primary

Addresses

Primary practice location

2505 Crossgate PL
Vestavia Hills, AL 35216-3116

Mailing address

2505 Crossgate PL
Vestavia Hills, AL 35216-3116
Phone (205) 478-7176

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2257ALMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1700514908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 CROSSGATE PL",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352163116",
            "telephone_number": "205-478-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 CROSSGATE PL",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352163116",
            "telephone_number": "205-478-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPPANA",
        "first_name": "SHILPA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "2257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia Hills, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.