Individual provider Active NPI

Kristen Elizabeth Shires, APRN

  • Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1730885765
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11528 Issued in CT
Practice address
86 New London Turnpike
Norwich, CT 06360
Phone
(860) 889-6967
Fax
(860) 885-1033
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11528 CT Primary

Addresses

Primary practice location

86 New London Turnpike
Norwich, CT 06360

Mailing address

86 New London Turnpike
Norwich, CT 06360
Phone (860) 889-6967

Other identifiers 1

IdentifierTypeStateIssuer
00809640MedicaidCT

Other names 1

  • Kristen Elizabeth Church-Reed Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230426002005 CT Practitioner - Nurse Practitioner 2466817465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul H Deutsch MD RPH LLCGroup PAC ID 9234260043, 2 clinicians

Practice addresses (Care Compare)

86 New London Tpke
Norwich, CT 06360-2616
Phone (860) 889-6967

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11528CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paul H Deutsch MD RPH LLC CurrentSince Jan 20, 2023 Accepting new patients
John a Pagnozzi MD LLC PastSince Jan 20, 2023 Accepting new patients

Locations

86 New London Tpke
Norwich, CT 06360
Phone (860) 887-6753

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFBAAA/Endpoint/HFBAAA
  • Direct secure messaging: kristen.churchreed@phdmrl.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HFBAAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1730885765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 NEW LONDON TURNPIKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-889-6967",
            "fax_number": "860-885-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 NEW LONDON TURNPIKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-889-6967",
            "fax_number": "860-885-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRES",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "11528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00809640",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "CHURCH-REED",
            "middle_name": "ELIZABETH",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.