Shelby King Fields, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5019543 Issued in NC

Practice address

125 W Catawba Ave
Mt Holly, NC 28120-1601

Phone

(704) 827-3014

NPI assigned

Apr 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Shelby Faith King 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

Registered Nurse

State licenses

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.

• Luke Medical Clinic, P.a.

  • Family Medicine Physician
  • Mount Holly, NC
  • NPI 1396918413

  Single Specialty

  NPD

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1679217996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 CLEVELAND AVE APT B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035199",
            "telephone_number": "205-222-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W CATAWBA AVE",
            "city": "MT HOLLY",
            "state": "NC",
            "postal_code": "281201601",
            "telephone_number": "704-827-3014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1527 Cleveland Ave Apt B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035199",
            "country_code": "US",
            "telephone_number": "052-222-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "SHELBY",
        "middle_name": "KING",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "317733",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "KING",
            "middle_name": "FAITH",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Mount Holly, NC
• Providers in Mount Holly, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.