Active NPI
Katie Lynn Shoup, PT
- Physical Therapist
- El Paso, TX
National Provider Identifier
1932869369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1355236
- Practice address
- 6601 Montana Ave Ste H
El Paso, TX 79925-2143 - Phone
- (915) 838-7604
- Fax
- (866) 218-8230
- NPI assigned
- Dec 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1355236 | TX | Primary |
Addresses
Primary practice location
6601 Montana Ave Ste H
El Paso, TX 79925-2143
Mailing address
6601 Montana Ave Ste H
El Paso, TX 79925-2143
Phone (915) 838-7604
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1355236 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rebecca Pokluda, P.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640563200000",
"number": "1932869369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 MONTANA AVE STE H",
"city": "EL PASO",
"state": "TX",
"postal_code": "799252143",
"telephone_number": "915-838-7604",
"fax_number": "866-218-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 MONTANA AVE STE H",
"city": "EL PASO",
"state": "TX",
"postal_code": "799252143",
"telephone_number": "915-838-7604",
"fax_number": "866-218-8230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOUP",
"first_name": "KATIE",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-27",
"last_updated": "2021-12-27",
"certification_date": "2021-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1355236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.