Kelly Shields, CNM

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

CNM12240 Issued in CA

Practice address

3343 4TH Ave
San Diego, CA 92103-5703

Phone

(619) 299-0840

Fax

(619) 299-0892

NPI assigned

Jun 21, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.shields.p1@direct.lakeside.nextgenshare.com

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Planada, CA
  • NPI 1235114745
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Best Start Birth Center

  • Birthing Clinic/Center
  • San Diego, CA
  • NPI 1154406148
  NPD (past)
• Best Start Midwife Services

  • Advanced Practice Midwife
  • San Diego, CA
  • NPI 1568800100
  NPD (past)
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265638993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035703",
            "telephone_number": "619-299-0840",
            "fax_number": "619-299-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035703",
            "telephone_number": "619-299-0840",
            "fax_number": "619-299-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "CNM12240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "619131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Shidler, RN, MSN, PHN
• Marie Patricia Shieh, MD
• Tiffany Nicole Shieh, PHARMD
• Shield California Health Care Center Inc
• Joseph Roman Shields, IDC
• Ken Shields
• Nathan Shields, RADT
• Nicholas A Shields
• Sharon L Shields, CRNA
• John Thomas Shier, D.C.

• Obstetrics & Gynecology Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.