Holly Shadle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP018629 Issued in PA

Practice address

740 High St
Suite 3002
Williamsport, PA 17701-3102

Phone

(570) 321-2820

NPI assigned

Mar 5, 2018

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
• Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

Merit-based Incentive Payment System (MIPS)

Final score

81.06 of 100Reported as group

Quality

62.07

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Susquehanna Physician Services

  • Physical Medicine & Rehabilitation Physician
  • Williamsport, PA
  • NPI 1629006606
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Evangelical Community Hospital

  • General Acute Care Hospital
  • Lewisburg, PA
  • NPI 1124076039
  Care Compare affiliation
• Upmc Williamsport

  • Land Ambulance
  • Williamsport, PA
  • NPI 1093890360

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • Ambulatory Surgical Clinic/Center
  • Williamsport, PA
  • NPI 1225500770

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • Ambulatory Surgical Clinic/Center
  • Williamsport, PA
  • NPI 1285719559

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • General Acute Care Hospital
  • Williamsport, PA
  • NPI 1609801976
  Care Compare affiliation
• Upmc Williamsport

  • Psychiatric Hospital Unit
  • Williamsport, PA
  • NPI 1649746488
  Care Compare affiliation
• Upmc Williamsport

  • General Acute Care Hospital
  • Williamsport, PA
  • NPI 1740365097
  Care Compare affiliation
• Upmc Williamsport

  • Primary Care Clinic/Center
  • Williamsport, PA
  • NPI 1982788048

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1235631490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 HIGH ST",
            "address_2": "SUITE 3002",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013102",
            "telephone_number": "570-321-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holly.n.shadle@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gerhard Carl Senula, MD
• David Servey
• Ceilia Severini, DO
• Susan A Seymour, LSW
• Amanda Shadle
• Emillie Cole Shaffer, LPTA
• Ralph Van Shaffer, DMD
• Mohammad Shafique
• Thomas Neil Shaner, D.O.
• Kaitlin Shanley

• Family Nurse Practitioner in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.