Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonathan Moore Shupe, MD

Individual provider Family Medicine Physician · NPI 1417241597

Jonathan Moore Shupe, MD is a Family Practice in Coeur D Alene, Idaho. Graduated from University of Connecticut School of Medicine in 2011, 15 years ago. Practices with Kootenai Health Inc, a 394-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
15
Trained at
University of Connecticut School of Medicine
Licensed in
ID
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1919 Lincoln Way 315
Coeur D Alene, ID 83814-2527
Phone: (208) 625-6000
Fax: (208) 625-6001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence M12445 (ID)

Record details

NPI number1417241597
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2011
Last updated in NPPESJuly 23, 2025
Certification dateJuly 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Coeur D Alene