Individual provider Active NPI

Heidi Jane Shawley, FNP-C

  • Family Nurse Practitioner
  • Bucksport, ME
National Provider Identifier
1053805309
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP181116 Issued in ME
Practice address
110 Broadway
Bucksport, ME 04416-4612
Phone
(207) 469-7371
NPI assigned
Jun 20, 2018
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP181116 ME Primary

Addresses

Primary practice location

110 Broadway
Bucksport, ME 04416-4612

Mailing address

110 Broadway
Bucksport, ME 04416-4612
Phone (207) 469-7371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20190716000117 ME Practitioner - Nurse Practitioner 9638404544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bucksport Regional Health CenterGroup PAC ID 9638135858, 30 clinicians

Practice addresses (Care Compare)

110 Broadway
Bucksport, ME 04416-4612
Phone (207) 469-7371

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP181116MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bucksport Regional Health Center CurrentSince Jul 16, 2019 Accepting new patients
Bucksport Regional Health Center CurrentSince Jul 16, 2019 Accepting new patients

Locations

110 Broadway
Bucksport, ME 04416
Phone (207) 469-7371

37 Commerce Park
Ellsworth, ME 04605
Phone (207) 667-2422

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 6

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1053805309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BROADWAY",
            "city": "BUCKSPORT",
            "state": "ME",
            "postal_code": "044164612",
            "telephone_number": "207-469-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BROADWAY",
            "city": "BUCKSPORT",
            "state": "ME",
            "postal_code": "044164612",
            "telephone_number": "207-469-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWLEY",
        "first_name": "HEIDI",
        "middle_name": "JANE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP181116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucksport, ME

Sources for this page

Verify at the official NPI Registry.