Mary Ellen Theresa Shields, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

30354 Issued in KY

Practice address

305 Estill St
Berea, KY 40403-1742

Phone

(859) 986-8418

Fax

(859) 986-6568

NPI assigned

May 26, 2006

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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: maryellenshields@kysjhspe.allscriptsdirect.net
• Direct secure messaging: mshields274949@direct.stlukeshealth.org

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.

• Neurosurgical Associates PSC

  • Neurological Surgery Physician
  • Lexington, KY
  • NPI 1235110925
  NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1285680553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "859-986-8418",
            "fax_number": "859-986-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-8418",
            "fax_number": "859-986-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MARY ELLEN",
        "middle_name": "THERESA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "30354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00357584",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64303548",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Piper Seyfrit
• Jennifer Michele Shelton, APRN
• Morrigan Ashley Shepherd
• Toni Alecia Shepherd, M.A.E.D
• Jamie Leeann Shepperson
• Rhonda Shockley, MS, OTR/L
• Leslie Ann Short, LMT
• Sipple & Sipple Chiropractic (Sipple's Chiropractic)
• Brandon Sipple, D.C.
• John Christopher Sipple, D.C.

• Surgery Physician in Berea, KY
• Providers in Berea, KY by specialty
• Surgery Physician in Kentucky

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.