Individual provider Active NPI

Denise Lynn Shields, ACNP-BC, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1609215425
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00420800 Issued in NJ
Practice address
3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone
(215) 615-4949
Fax
(215) 615-0829
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP012830 PA
Acute Care Nurse Practitioner 363LA2100X 26NJ00420800 NJ Primary

Addresses

Primary practice location

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2 East
Philadelphia, PA 19104-5127
Phone (215) 615-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140304000615 NJ Practitioner - Nurse Practitioner 7618107079
I20191118001182 PA Practitioner - Nurse Practitioner 7618107079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00420800NJMDAcute Care Nurse Practitioner
SP012830PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Dec 2, 2019 Accepting new patients
University of Penn - Medical Group CurrentSince Dec 2, 2019 Accepting new patients

Locations

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1609215425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "DENISE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ACNP-BC, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP012830",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00420800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.