Individual provider Active NPI

Jennifer Ann Shirley, DNP, APRN, AGNP-C

  • Adult Health Nurse Practitioner
  • Concord, NC
National Provider Identifier
1275209934
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5014954 Issued in NC
Practice address
101 Cabarrus Ave E
Concord, NC 28025-3699
Phone
(855) 743-2247
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SHIR-I33S7 NC
Nurse Practitioner 363L00000X 279549 NC
Adult Health Nurse Practitioner 363LA2200X 5014954 NC Primary

Addresses

Primary practice location

101 Cabarrus Ave E
Concord, NC 28025-3699

Mailing address

7318 Waterwheel St SW
Concord, NC 28025-6714
Phone (704) 932-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20220104002870 NC Practitioner - Nurse Practitioner 8426449240 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians
Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Practice addresses (Care Compare)

101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247

212 S Tryon St
Suite 1000
Charlotte, NC 28281-0006
Phone (855) 743-2247

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
279549NCMDNurse Practitioner
SHIR-I33S7NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Wholehealth, PLLC Nurse Practitioner CurrentSince Sep 22, 2021 Accepting new patients
Eventus WH Southeast, LLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Eventus Wholehealth Aco LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Eventus WH PLLC Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Eventus Value Care, LLC CurrentSince Jul 5, 2022 Accepting new patients

Locations

212 S Tryon St
Ste 1000
Charlotte, NC 28281
Phone (512) 575-8028

2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1275209934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7318 WATERWHEEL ST SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280256714",
            "telephone_number": "704-932-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "855-743-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "DNP, APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "SHIR-I33S7",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "279549",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5014954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.