Karissa V Shields, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6144 Issued in TN

Practice address

111 Otis Smith Dr
Clarksville, TN 37043-8940

Phone

(931) 553-6666

Fax

(931) 553-6681

NPI assigned

Feb 17, 2015

Last updated

Oct 7, 2024By 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 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Brentwood, TN, CCN 447107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: karissa.shields.1@31800.direct.athenahealth.com

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.

• Iris Medical Group

  • Primary Care Clinic/Center
  • Brentwood, TN
  • NPI 1851025902
  Medicare reassignment Care Compare group NPD
• Grace Pediatrics PLLC

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1467781690
  NPD (past)
• Iris Wound Care, PC

  • Clinic/Center
  • Brentwood, TN
  • NPI 1568273605
  NPD (past)
• Rainbow Enterprise PLC

  • Pediatrics Physician
  • Clarksville, TN
  • NPI 1609123884
  NPD (past)
• Ellsworth Cox Pediatric Dentistry LLC

  dba Anthem Pediatric Dentistry

  • Pediatric Dentistry
  • Henderson, NV
  • NPI 1417041146
  NPD (past)
• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD (past)

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

• Amedisys Tennessee, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Brentwood, TN
  • NPI 1972551794
  Care Compare affiliation

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1467843011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-553-6666",
            "fax_number": "931-553-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-553-6666",
            "fax_number": "931-553-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "KARISSA",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1586",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504311",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Allese Shepherd
• Lance A Sherley, DO
• Nancy Sherman
• Elizabeth Sherr, LPC-MHSP, NCC
• John D Shields, MD
• Tammy Shields, MD
• Amber Shimon, RN
• Tianna Shiokari, BEHAVIOR TECHNICIAN
• Melody Shipley, LPC-MHSP
• Shelley Leeann Shipley

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.