Jennifer Michelle Shively, N.P.

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

20141 Issued in CA

Practice address

455 S Main St
Orange, CA 92868-3835

Phone

(714) 204-3277

NPI assigned

Sep 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/7477d6d6-6e4b-48c8-a228-9a3bdab172a0/

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1003165267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-204-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683835",
            "telephone_number": "714-204-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CA",
            "license": "20141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Michael Shipley
• Sholay Sahar Shirazi, ASW
• Layla Geasu Shirkhoda, M.D.
• Layla Shirkhorshidi, PA-C
• Ali Shishehgar
• Mayada Shmara, DDS
• Gary Shmorgon
• Kyna Z Shnayderman, M.D.
• Inna Shniter, M.D.
• Dorothy Susan Shofner, CERTIFIED MASSAGE TH

• Critical Care Pediatric Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Critical Care Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.