Individual provider Active NPI

Beverly Anne Shields, NP

  • Family Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1407484744
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
59884 Issued in NM
Practice address
2000 W 21St St Ste R1
Clovis, NM 88101-4098
Phone
(575) 935-0944
NPI assigned
Mar 31, 2020
Last updated
Mar 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 59884 NM Primary

Addresses

Primary practice location

2000 W 21St St Ste R1
Clovis, NM 88101-4098

Mailing address

42121 US Highway 70
Portales, NM 88130-9054
Phone (575) 356-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20200506000936 NM Practitioner - Nurse Practitioner 7618308776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 W 21St St
Suite R1
Clovis, NM 88101-4098
Phone (575) 935-0944

42121 US Hwy 70
Portales, NM 88130-9054
Phone (575) 356-6652

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59884NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roosevelt County Special Hospital District CurrentSince May 15, 2020 Accepting new patients
Roosevelt County Special Hospital District CurrentSince May 15, 2020 Accepting new patients
Roosevelt County Special Hospital District Past Accepting new patients

Locations

2000 W 21st St
Ste R1
Clovis, NM 88101
Phone (505) 763-3445

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

Interoperability endpoints

  • Direct secure messaging: beverlyshields@rghnm.medalliesdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1407484744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42121 US HIGHWAY 70",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881309054",
            "telephone_number": "575-356-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W 21ST ST STE R1",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014098",
            "telephone_number": "575-935-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "BEVERLY",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "59884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.