Individual provider Active NPI

Ann Lewis Shields, P.N.P.

  • Pediatric Nurse Practitioner
  • Glen Allen, VA
National Provider Identifier
1730580085
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024172019 Issued in VA
Practice address
4687 Pouncey Tract Rd
Glen Allen, VA 23059-5802
Phone
(804) 422-5437
NPI assigned
Sep 5, 2014
Last updated
Sep 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024172019 VA Primary

Addresses

Primary practice location

4687 Pouncey Tract Rd
Glen Allen, VA 23059-5802

Mailing address

1400 1/2 Bellevue Ave
Richmond, VA 23227-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20240829000492 UT Practitioner - Nurse Practitioner 3274072632 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024172019VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 15, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 15, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Pediatrics Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

201 W Layton Pkwy
Ste 1C
Layton, UT 84041
Phone (801) 387-4500

4403 Harrison Blvd
Ste 4875
Ogden, UT 84403
Phone (801) 387-4500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1730580085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 1/2 BELLEVUE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232274005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4687 POUNCEY TRACT RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595802",
            "telephone_number": "804-422-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "ANN LEWIS",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024172019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.