Active NPI
Jennifer Ann Shirley, DNP, APRN, AGNP-C
- Adult Health Nurse Practitioner
- Concord, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 5014954
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
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 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 279549 | NC | MD | Nurse Practitioner |
| SHIR-I33S7 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Wholehealth, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Eventus WH Southeast, LLC | Nurse Practitioner | Current | Accepting new patients |
| Eventus Wholehealth Aco LLC | Nurse Practitioner | Current | Accepting new patients |
| Eventus WH PLLC Care, LLC | Current | Accepting new patients | |
| Eventus Value Care, LLC | Current | 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
- 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.
-
- Geriatric Medicine (Family Medicine) Physician
- Charlotte, NC
- NPI 1487494811
Nurse Practitioner
-
- Family Medicine Physician
- Concord, NC
- NPI 1013680503
-
- Geriatric Medicine (Internal Medicine) Physician
- Concord, NC
- NPI 1023796307
Nurse Practitioner
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1639990658
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.