Marie Carol Shields, NURSE PRACTITIONER,

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110011858 Issued in FL

Practice address

5036 SW 87TH Ter
Cooper City, FL 33328-4334

Phone

(954) 394-9758

NPI assigned

Jul 2, 2020

Last updated

May 5, 2022By 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 2

Addresses

Other identifiers 2

Other names 1

• Marie Shields Professional name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health System Sunbelt, Inc.Group PAC ID 6406849256, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshields5071272@adventhealth.direct-ci.com

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.

• Adventist Health System Sunbelt, Inc.

  dba AdventHealth Centra Care

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1073565610
  Medicare reassignment Care Compare group
• Adventist Health System/ Sunbelt, Inc.

  dba AdventHealth Centra Care - Southern Trace

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1396605440

  Family

  NPD
• Adventist Health System/Sunbelt, Inc.

  dba AdventHealth Centra Care -KIds Winter Park

  • Urgent Care Clinic/Center
  • Winter Park, FL
  • NPI 1194122200

  Family

  NPD

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1255958518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 SW 87TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284334",
            "telephone_number": "195-439-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 SW 87TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284334",
            "telephone_number": "954-394-9758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5036 SW 87th Ter",
            "address_purpose": "LOCATION",
            "city": "Cooper City",
            "state": "FL",
            "postal_code": "333284334",
            "country_code": "US",
            "telephone_number": "954-394-0758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MARIE",
        "middle_name": "CAROL",
        "credential": "NURSE PRACTITIONER,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "110011858",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN--9233024",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "APRN11011858",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "SHIELDS",
            "credential": "NURSE PRACTITIONER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Megan Marie Shanks, ITDS
• Shawn a. McClure DMD, MD
• Marilyn Sylvia Sheehy, L
• Shibu Varughese MD PA
• Shick Shadel of Florida LLC
• Charles Irving Shofnos, DDS
• Jamie Lynne Shore, DDS
• Cristina Piseu Sicoia, OD
• Nellie Simkin Zeltsman, PHARM.D.
• Roger Elliott Sinkoe, D.P.M.

• Family Nurse Practitioner in Cooper City, FL
• Providers in Cooper City, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.