Individual provider Active NPI

Stephen Wyatt Shield, M.D.

  • Allergy & Immunology Physician
  • Williamsburg, VA
National Provider Identifier
1073590071
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101049643 Issued in VA
Practice address
1144 Professional Dr
Williamsburg, VA 23185-3330
Phone
(757) 259-0443
Fax
(757) 259-0450
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 0101049643 VA Primary

Addresses

Primary practice location

1144 Professional Dr
Williamsburg, VA 23185-3330

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
1073590071MedicaidVA
00Y225A01OtherVAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100121000081 VA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 0749322394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Eastern Virginia Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

1144 Professional Dr
Williamsburg, VA 23185-3330
Phone (757) 259-0443

Hospital & facility affiliations

  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
  • Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Past Accepting new patients

Locations

1144 Professional Dr
Williamsburg, VA 23185
Phone (757) 259-0443

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1073590071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 PROFESSIONAL DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853330",
            "telephone_number": "757-259-0443",
            "fax_number": "757-259-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELD",
        "first_name": "STEPHEN",
        "middle_name": "WYATT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101049643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073590071",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00Y225A01",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.