Shane M Sopp, MD PC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

SHANE M SOPP, MD PC

Practice address

4900 Broad Rd
CGH Pob Suite 2V
Syracuse, NY 13215-2265

Phone

(315) 492-5005

Fax

(315) 492-5324

NPI assigned

Sep 26, 2005

Organization subpart

No

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

Authorized official

Name

Shane M Sopp, MD

Title

Owner

Phone

(315) 492-5005

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig S Reynolds, MD

  • Anesthesiology Physician
  • Syracuse, NY
  • NPI 1215931142
  NPD (past)
• Jacqueline Joy Gagen, CNM, FNP

  • Family Nurse Practitioner
  • Sayre, PA
  • NPI 1811964281

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1952397705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2003",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574503",
            "telephone_number": "315-446-3904",
            "fax_number": "315-445-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "address_2": "CGH POB SUITE 2V",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5005",
            "fax_number": "315-492-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE M SOPP, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "SOPP",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-492-5005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01992896",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott William Shallish, D.M.D.
• Lyda A Shambo, CRNA
• Szu-Lin Shan
• Paul Andrew Shanahan, MD
• Sanjana Shandilya
• Robert Joseph Shane, DC
• Krista Marie Shanholtz, FNP, RN
• Maribeth Shanley
• Paul Shanley, MD
• Donna Lynn Shannon-Jones

• Gynecology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.