Active NPI
Kristine Lea Shaver, PS
- Physician Assistant
- Madrid, IA
National Provider Identifier
1255450169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001044
- Practice address
- 623 W North St
Madrid, IA 50156-1023 - Phone
- (515) 795-4300
- NPI assigned
- Mar 29, 2007
- Last updated
- Aug 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001044 | IA | Primary |
Addresses
Primary practice location
623 W North St
Madrid, IA 50156-1023
Mailing address
623 W North St
Madrid, IA 50156-1023
Phone (515) 795-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001044 | IA | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinics, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Obstetrics & Gynecology Physician
- Des Moines, IA
- NPI 1508741505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376524800000",
"number": "1255450169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 W NORTH ST",
"city": "MADRID",
"state": "IA",
"postal_code": "501561023",
"telephone_number": "515-795-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 W NORTH ST",
"city": "MADRID",
"state": "IA",
"postal_code": "501561023",
"telephone_number": "515-795-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVER",
"first_name": "KRISTINE",
"middle_name": "LEA",
"credential": "PS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2013-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "001044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madrid, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.