Jaclyn Shields

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4008949 Issued in KY

Practice address

231 E Chestnut St
Louisville, KY 40202-1821

Phone

(502) 494-9521

NPI assigned

Jul 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Gerard Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096
  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Endocrinology Physician
  • Louisville, KY
  • NPI 1548801186

  Family

  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1013696798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SUNSET DR",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403421458",
            "telephone_number": "502-494-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-494-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "KY",
            "license": "1138276",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4008949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "GERARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aarushi Shewale
• Ping Shi
• Shields & Fidanza, LLC
• Shields & Fidanza, LLC
• Christopher B Shields, MD
• James Francis Shields, PSY.D
• Kayla Maria Shields, MD
• Mary Kathryn Shields, DMD
• Whitney Danielle Shields, CRNA
• Tina Shier

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.