Provider Demographics
NPI:1083380307
Name:SHUPE, MEGAN JUNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JUNE
Last Name:SHUPE
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:JUNE
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4901 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-5293
Mailing Address - Country:US
Mailing Address - Phone:501-791-3331
Mailing Address - Fax:
Practice Address - Street 1:4901 NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-5293
Practice Address - Country:US
Practice Address - Phone:501-791-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist