Kristy Lynn Shields, MSED

Primary specialty

SpecialistTaxonomy code 174400000X

License

1656612 Issued in NY

Practice address

640 Jefferson Ave
Rochester, NY 14611-3548

Phone

(585) 436-0362

NPI assigned

Jan 28, 2019

Last updated

Jan 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristy Koring Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Start Pediatric Services

  • Early Intervention Provider Agency
  • Fairport, NY
  • NPI 1467618231
  NPD (past)

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1205390887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 N MAIN ST",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501434",
            "telephone_number": "585-377-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JEFFERSON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146113548",
            "telephone_number": "585-436-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1656612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEACHER CERTIFICATION",
            "identifier": "1656612",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "KORING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hangchuan Shi, MD, PHD
• Xingyi Shi, MD
• Maria Christina Shiau, M.D.
• J William Shields, MD
• Jessica Lynn Shields, PA
• Amde Selassie Shifera, M.D., PH.D.
• Louisa Shiffer
• Danielle Rae Shifflet, NP
• Robin Barnett Shiffrin, M.S.ED, M.S. MFT
• Abigail Shilvock, MD

• Specialist in Rochester, NY
• Providers in Rochester, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.