NPIMap

Individual provider Active NPI

Lynn Marie Shields, ACNP/FNP

  • Primary Care Nurse Practitioner
  • Colorado City, CO
National Provider Identifier
1023240645
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5987 Issued in CO
Practice address
4491 Bent Brothers Blvd
Colorado City, CO 81019-9990
Phone
(719) 595-7525
Fax
(719) 595-7965
NPI assigned
Aug 14, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5987 CO
Family Nurse Practitioner 363LF0000X 5988 CO
Primary Care Nurse Practitioner 363LP2300X 5987 CO Primary

Addresses

Primary practice location

4491 Bent Brothers Blvd
Colorado City, CO 81019-9990

Mailing address

PO Box 560825
Denver, CO 80256-0825
Phone (719) 595-7417

Other practice location 1

1600 N Grand Ave
Suite 245
Pueblo, CO 81003-2700
Phone (719) 595-7040

Other identifiers 1

IdentifierTypeStateIssuer
06358306MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000406 CO Practitioner - Nurse Practitioner 6305986423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

3670 Parker Blvd
Suite 101
Pueblo, CO 81008-2285
Phone (719) 562-2900

3676 Parker Blvd
Suite 390
Pueblo, CO 81008-2215
Phone (719) 595-7780

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4491 Bent Brothers Blvd
Suite a
Colorado City, CO 81019-9990
Phone (719) 595-7525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5988COMDChiropractor
5987COMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1600 N Grand Ave
Ste 245
Pueblo, CO 81003
Phone (719) 296-6877

Organizations & group practices 2

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.

Hospital & facility affiliations 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023240645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7417",
            "fax_number": "719-542-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 BENT BROTHERS BLVD",
            "city": "COLORADO CITY",
            "state": "CO",
            "postal_code": "810199990",
            "telephone_number": "719-595-7525",
            "fax_number": "719-595-7965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Grand Ave",
            "address_2": "Suite 245",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032700",
            "country_code": "US",
            "telephone_number": "719-595-7040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ACNP/FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "5987",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "5988",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "5987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06358306",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado City, CO

Sources for this page

Verify at the official NPI Registry.