Jason Shupe, D.O., an Osteopathic Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

JASON SHUPE, D.O., AN OSTEOPATHIC CORPORATION

Practice address

554 E Foothill Blvd Ste 120
San Dimas, CA 91773-1222

Phone

(909) 248-3437

Fax

(844) 380-6565

NPI assigned

Jun 26, 2019

Organization subpart

No

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

Authorized official

Name

Jason Shupe, DONPI 1679914469

Title

Ceo

Phone

(909) 248-3437

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jason Shupe, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • San Dimas, CA
  • NPI 1679914469
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1992366223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 E FOOTHILL BLVD STE 120",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731222",
            "telephone_number": "909-248-3437",
            "fax_number": "844-380-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 E FOOTHILL BLVD STE 120",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731222",
            "telephone_number": "909-248-3437",
            "fax_number": "844-380-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON SHUPE, D.O., AN OSTEOPATHIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "SHUPE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-248-3437",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanny Jachin, PT
• Danielle Sheree Jackson
• Aamir Zain Jamal, M.D.
• Elhama Jami
• Jasmine Rae Jancan
• Vanessa Jauregui
• Ashlie Renee Javier
• Lyndsie Von Javier, DPT
• Robert A Jennings, LMFT
• Yuliya Jensen

• Medical Specialty Clinic/Center in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.