Individual provider Active NPI

Karen Shaw

  • Pediatric Nurse Practitioner
  • Clyde, NC
National Provider Identifier
1134551435
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5008966 Issued in NC
Practice address
15 Facility Dr
Clyde, NC 28721-9438
Phone
(828) 452-2211
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5008966 NC Primary

Addresses

Primary practice location

15 Facility Dr
Clyde, NC 28721-9438

Mailing address

15 Facility Dr
Clyde, NC 28721-9438
Phone (828) 452-2211

Other names 1

  • Karen Hjelmeland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20140618000160 SC Practitioner - Nurse Practitioner 8628292406 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008966NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Mar 22, 2014 Accepting new patients
Shriners Hospitals for Children CurrentSince Mar 22, 2014 Accepting new patients
Haywood Pediatric and Adolescent Medicine Group, P.a. PastSince Oct 1, 2023 Accepting new patients

Locations

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7951

Interoperability endpoints

  • Direct secure messaging: karen.shaw.1@20223.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20223/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1134551435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FACILITY DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219438",
            "telephone_number": "828-452-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FACILITY DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287219438",
            "telephone_number": "828-452-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5008966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "HJELMELAND",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.