JEROMY MICHAEL SHOUP (NPI# 1053960120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053960120 |
| Entity Type | Individual |
| Full Name | JEROMY MICHAEL SHOUP |
| Credential | NP |
| Practice Address |
517 N Concord Rd Crawfordsville IN 47933-9002 |
| Mailing Address |
2910 Gadsen Cir N Carmel IN 46032-8392 |
| Practice Telephone | 3175172339 |
| Mailing Telephone | 3175172339 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
28215271A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
517 N CONCORD RD |
| City | CRAWFORDSVILLE |
| State | IN |
| Zip Code | 47933-9002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760816623 | Putnam County Hospital | Skilled Nursing Facility | 517 N Concord Rd, Crawfordsville, IN 47933-9002 | 2013-08-28 |
| 1518581826 | Danelle Shubert | Occupational Therapy Assistant | 517 N Concord Rd, Crawfordsville, IN 47933-9002 | 2020-06-02 |
| 1861868069 | Andrea Irwin | Physical Therapy Assistant | 517 N Concord Rd, Crawfordsville, IN 47933-9002 | 2015-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093370454 | Mh Nursing of Indiana, PC | Nurse Practitioner | 600 Sr32 West, Crawfordsville, IN 47933 | 2019-05-01 |
| 1336678192 | Latoyia Cherdise Austin | Nurse Practitioner | 600 Sr 32 West, Crawfordsville, IN 47933 | 2017-06-06 |
| 1154579597 | Crossroads Orthotics & Consultation, Inc. | Prosthetic/Orthotic Supplier | 821 S Washington, Crawfordsville, IN 47933 | 2008-08-27 |
| 1487849063 | Assisted Living Concepts Inc | Assisted Living Facility | 1719 South Elm Street, Crawfordsville, IN 47933 | 2007-09-07 |
| 1912129503 | Stephen W. Rasmussen | Dentist | 1485 S. Grant Ave., Suite B, Crawfordsville, IN 47933 | 2007-05-03 |
| 1932244597 | Stephanie Elaine Ford | Physical Therapist | 402 W Market, Crawfordsville, IN 47933 | 2007-02-21 |
| 1285776906 | Thomas A. Clemens | Optometrist | 1615 U.S. 231 South, Crawfordsville, IN 47933 | 2007-02-12 |
| 1730256819 | Nancy Jane Davis | Social Worker | 468 N Woodland Heights Dr, Crawfordsville, IN 47933 | 2006-11-30 |
| 1881761963 | Jennifer Sue Slavens | Counselor | 468 N Woodland Heights Drive, Crawfordsville, IN 47933 | 2006-11-30 |
| 1639249188 | Regina Lee Endicott | Nurse Practitioner | 4537 S Nucor Rd, Crawfordsville, IN 47933 | 2006-11-09 |
| Find all providers in zip 47933 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550445 | Indiana University Health Fort Wayne Physicians, LLC | Family Medicine | 7230 Engle Rd Ste 100, Fort Wayne, IN 46804-2234 | 2020-08-28 |
| 1336751312 | Indystathealthedu, LLC | Family Medicine | 5699 E 71st St Ste 1a, Indianapolis, IN 46220-3987 | 2020-08-20 |
| 1356864219 | Mobile Primary Care, LLC | Family Medicine | 14074 Trade Center Dr Ste 213, Fishers, IN 46038-4592 | 2017-07-24 |
| 1962822106 | Patient Care Services Team | Family Medicine | 939 Conner St Ste 200, Noblesville, IN 46060-2622 | 2014-04-25 |
| 1396002408 | Indiana Home Care Physicians Inc | Family Medicine | 7895 Broadway Ste V, Merrillville, IN 46410-5529 | 2012-04-13 |
| 1275802993 | Certified Physician Solutions | Family Medicine | 541 N Park Ave, Indianapolis, IN 46202-3513 | 2011-12-27 |
| 1336377670 | Nikki L O'rourke | Family Medicine | 1919 E 52nd St Ste 200, Indianapolis, IN 46205-1381 | 2009-06-25 |
| 1932304417 | George W Merkle Md PC | Family Medicine | 360 N Main St Ste A, Bluffton, IN 46714-2041 | 2007-06-15 |
| 1891871026 | Mohammad A Rahmany | Family Medicine | 2914 Highway Ave, Highland, IN 46322-1656 | 2006-10-31 |
| 1780777177 | Lula G. Porter | Family Medicine | 4666 Radnor Road, Indianapolis, IN 46226-2154 | 2006-09-30 |
| Find all providers with the same taxonomy | ||||
| City | CRAWFORDSVILLE |
| Zip Code | 47933 |
Please comment or provide details below to improve the information on JEROMY MICHAEL SHOUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.