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General NPI Number Information
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NPI Number | 1437042165
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Entity Type | Organization
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Legal Business Name | SHAPE HEALTH, LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 6202 ALCHEMY ST
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City | LAS CRUCES
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State | NM
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Zip | 88012-0850
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Country | US
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Telephone | 575-520-2824
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Fax |
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Provider Business Mailing Address
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Address Line | 6202 ALCHEMY ST
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City | LAS CRUCES
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State | NM
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Zip | 88012-0850
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Country | US
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Telephone | 575-520-2824
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | JOSIAH FIELDER
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Credential |
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Telephone | 575-520-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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