Stephanie Sapna Shah, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD56582 Issued in TN

Practice address

Building 52 Lake Drive
Mountain Home, TN 37684-0699

Phone

(423) 439-8000

Fax

(423) 439-2200

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Carolina Dept of Mental Health Accounting Office

  • Psychiatric Hospital
  • Anderson, SC
  • NPI 1376595041
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment
• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  NPD (past)
• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rock Hill, SC
  • NPI 1568476885
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1942561816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FAISON DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033210",
            "telephone_number": "803-935-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 52 LAKE DRIVE",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-8000",
            "fax_number": "423-439-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Medical Park, Ste 141",
            "address_2": "Child/Adolescent Psychiatry De",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29201",
            "country_code": "US",
            "telephone_number": "803-434-1422",
            "fax_number": "803-434-4062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Faison Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292033210",
            "country_code": "US",
            "telephone_number": "803-898-1593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "STEPHANIE",
        "middle_name": "SAPNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "38408",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "MD56582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles William Schutter II, P.T.
• Jennifer Renee Sears, AU.D.
• John Adam Seneker, PHARM.D.
• James Travis Sexton, D.O.
• Binoy Jagdish Shah, M.D.
• Kevin J Sharkey, PH.D.
• Diane C. Shelton
• Jared Michael Shelton, MD
• David Robert Shields Jr., MSW
• Roxy L Shortridge, FNP-BC

• Child & Adolescent Psychiatry Physician in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Child & Adolescent Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.