Mary Kathleen Schupp, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP1104662 Issued in FL

Practice address

100 Whetstone PL Ste 208
St Augustine, FL 32086-5775

Phone

(904) 447-7377

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADBCAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flagler Family Medicine P a

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1215080809
  Medicare reassignment NPD
• Flagler Family Nursing Home Care LLC

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1679172779
  Medicare reassignment NPD
• Flagler Family Medicine PA

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
  • NPI 1821406679
  NPD
• Urology Assoc. of N.E. Florida

  • Urology Physician
  • Orange Park, FL
  • NPI 1447235411
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1851445860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL STE 208",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL STE 208",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865775",
            "telephone_number": "904-447-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1104662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020952200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Schuld, DPT
• Erica Danielle Schulte, PMHNP
• Madison Schultz
• Allyson Jo Schumacher, ARNP
• Lynn Schumacher
• Pamela A Schutter, LMFT
• Megan Taylor Schweitzer, DC
• Dana Scioli, DPT
• Scott D McDowall PLLC
• Scott Fechter Chiropractic Inc

• Family Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.

Verify at the official NPI Registry.