Individual provider Active NPI

Laura Elizabeth Hough Shields, NP

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1093350472
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024178775 Issued in VA
Practice address
3802 Poplar Hill Rd Ste C
Chesapeake, VA 23321-5523
Phone
(757) 673-8383
Fax
(757) 483-9350
NPI assigned
Nov 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001230792 VA
Lactation Consultant (Registered Nurse) 163WL0100X L-104779 VA
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 0024178775 VA Primary

Addresses

Primary practice location

3802 Poplar Hill Rd Ste C
Chesapeake, VA 23321-5523

Mailing address

PO Box 7068
Portsmouth, VA 23707-0068
Phone (757) 757-6738

Other practice location 1

612 Kingsborough Sq Ste 200
Chesapeake, VA 23320-5054
Phone (757) 842-4120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200527001795 VA Practitioner - Nurse Practitioner 9638590706 Reassigns benefits to 1 organization
I20230531002747 DC Practitioner - Certified Nurse Midwife (CNM) 9638590706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001230792VAMDRegistered Nurse
L-104779VAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Maryland PC CurrentSince Apr 16, 2023 Accepting new patients
Obhg Maryland PC CurrentSince Apr 16, 2023 Accepting new patients
Bayview Physician Services, PC CurrentSince Apr 19, 2020 Accepting new patients
Bayview Physician Services, PC CurrentSince Apr 19, 2020 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients

Locations

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

612 Kingsborough Sq
Ste 200
Chesapeake, VA 23320
Phone (757) 436-0167

3802 Poplar Hill Rd
Ste C
Chesapeake, VA 23321
Phone (757) 483-4600

3241 Western Branch Blvd
Ste A
Chesapeake, VA 23321

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1573257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1093350472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7068",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070068",
            "telephone_number": "757-757-6738",
            "fax_number": "757-483-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 POPLAR HILL RD STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215523",
            "telephone_number": "757-673-8383",
            "fax_number": "757-483-9350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Kingsborough Sq Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233205054",
            "country_code": "US",
            "telephone_number": "757-842-4120",
            "fax_number": "757-819-1413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH HOUGH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-09",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001230792",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-104779",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024178775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.