Cynthia J Shively, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP4137 Issued in AZ

Practice address

16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356

Phone

(602) 996-4747

Fax

(602) 953-5466

NPI assigned

May 11, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Surgical Clinics, LTDGroup PAC ID 3577549021, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Valley Surgical Clinics, LTD

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1962440602
  Medicare reassignment Care Compare group NPD Authorized official
• Acute Care Surgical Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Phoenix, AZ
  • NPI 1225311871
  Medicare reassignment NPD Authorized official
• Valley Surgical Colorectal Specialists LLC

  • Colon & Rectal Surgery Physician
  • Phoenix, AZ
  • NPI 1942167424
  Authorized official Same address or phone

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316997349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 N 40TH ST STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323356",
            "telephone_number": "602-996-4747",
            "fax_number": "602-953-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN115612",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADV. PRACTITIONER",
            "identifier": "AP4137",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "RN115612",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley S Smith M D PLLC
• Katherine Shirley
• Shirvan, Inc.
• Michael Shishov, MD
• Naini Shiswawala
• Richard Shively, PT, DPT
• Lara Shleef, PA
• Marie Shlezar
• Hillary Gayle Shluker, LPC
• Darren E Shobe, P.A.-C.

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.