Misty R Shields

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6960909-8900 Issued in UT

Practice address

1717 W Packsaddle Cir
Bluffdale, UT 84065-1299

Phone

(360) 597-8320

NPI assigned

Mar 14, 2023

Last updated

Mar 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amore Mental Health

  • Adult Mental Health Clinic/Center
  • Lehi, UT
  • NPI 1366397978
  NPD (past) Authorized official

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1003517343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W PACKSADDLE CIR",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840651299",
            "telephone_number": "360-597-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W PACKSADDLE CIR",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840651299",
            "telephone_number": "360-597-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MISTY",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "6960909-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renaissance Ranch Bluffdale Women's Program
• Bryce Rodabough
• Christopher David Roller, PHARM D.
• Brittan Ashley Rooney, PT, DPT, OCS
• Holly M Scott
• Smiths Food & Drug Centers Inc (Smith's Pharmacy #212)
• South Valley Women's Health Care, PC
• Southwest Personal Injury
• Cory Speaker, LCMHC
• Chad G Spencer, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Bluffdale, UT
• Providers in Bluffdale, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.