Kristen Shaheen Williams, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-05568 Issued in NC

Practice address

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2441

Phone

(704) 786-6521

NPI assigned

Apr 23, 2015

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 names 1

• Ms. Kristen Frances Shaheen Former name

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• North Carolina Internal Medicine, P.C

  • Internal Medicine Physician
  • Cary, NC
  • NPI 1518968056
  Medicare reassignment
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1144336587
  NPD (past)

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1588051981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE",
            "address_2": "STE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252443",
            "telephone_number": "252-904-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE",
            "address_2": "SUITE 102",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-786-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTEN",
        "middle_name": "SHAHEEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-05568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "SHAHEEN",
            "middle_name": "FRANCES",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Howard Williams
• Janelle H Williams
• Jennifer Renee Williams
• Jessica Williams
• Kendaisha Williams
• Lakenya S. Williams, PMHNP-BC
• Landirs S Williams, MD
• Logan Williams
• Meikayla Zhane Williams
• Ondrea Williams, LPN

• Medical Physician Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.