Individual provider Active NPI

Penelope Shields, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1033508478
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277003886 Issued in IL
Practice address
1005 Health Center Dr Ste 102
Mattoon, IL 61938-4693
Phone
(217) 258-4042
Fax
(217) 258-4053
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209012444 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209-012444 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277003886 IL Primary

Addresses

Primary practice location

1005 Health Center Dr Ste 102
Mattoon, IL 61938-4693

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

319 Indian Hills Dr
Rantoul, IL 61866-1456
Phone (217) 258-4042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20150511001745 IL Practitioner - Nurse Practitioner 8325367527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1005 Health Ctr Dr
Suite 102
Mattoon, IL 61938-4637
Phone (217) 258-4042

Hospital & facility affiliations

  • Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-012444ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jul 4, 2017 Accepting new patients
Sarah Bush Lincoln Health Center Nurse Practitioner Past Accepting new patients

Locations

700 W Lincoln Ave
Ste 200
Charleston, IL 61920
Phone (217) 238-4042

1005 Health Center Dr
Ste 102
Mattoon, IL 61938
Phone 21734234002414

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1033508478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 102",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384693",
            "telephone_number": "217-258-4042",
            "fax_number": "217-258-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 Indian Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Rantoul",
            "state": "IL",
            "postal_code": "618661456",
            "country_code": "US",
            "telephone_number": "217-258-4042",
            "fax_number": "217-258-4053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "PENELOPE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012444",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209-012444",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277003886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.