Mikaela Leslie Shields, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5200 Issued in NH

Practice address

1040 Whittier Hwy
Moultonborough, NH 03254

Phone

(603) 273-1570

NPI assigned

Aug 10, 2023

Last updated

Aug 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Mountain Physical Therapy PLLCGroup PAC ID 2567889165, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• White Mountain Physical Therapy, PLLC

  • Physical Therapist
  • Moultonborough, NH
  • NPI 1497372585
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1073296695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 121",
            "city": "CORNISH",
            "state": "ME",
            "postal_code": "040200121",
            "telephone_number": "207-272-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WHITTIER HWY",
            "city": "MOULTONBOROUGH",
            "state": "NH",
            "postal_code": "03254",
            "telephone_number": "603-273-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MIKAELA",
        "middle_name": "LESLIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "5200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meadow Pond Animal Hopsital
• Merkaba Sacred Healing & Counseling PLLC
• Moultonborough School District
• Heather L Nelson, EDS
• Linden North, DVM
• Sweatt Investments Dba Aging Excellence
• Town of Moultonborough (Moultonborough Visiting Nurse Service)
• White Mountain Physical Therapy, PLLC

• Physical Therapist in Moultonborough, NH
• Providers in Moultonborough, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.