Charmaine A Shields, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN1059196 Issued in DC

Practice address

198 E 121St St FL 5
New York, NY 10035-3523

Phone

(646) 755-6461

NPI assigned

Sep 19, 2014

Last updated

Nov 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Charmaine A Reynolds Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: charmaine.shields.1@24989.direct.athenahealth.com
• Direct secure messaging: charmaine.shields@cinq-nyipa.medentdirect.com

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.

• Seamen's Society for Children and Families

  • Voluntary or Charitable Agency
  • Staten Island, NY
  • NPI 1518137033
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1760884852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 E 121ST ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353523",
            "telephone_number": "646-755-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E 121ST ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353523",
            "telephone_number": "646-755-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Bay St",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103012511",
            "country_code": "US",
            "telephone_number": "718-447-7740 x4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "CHARMAINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345764",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1059196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARMAINE",
            "last_name": "REYNOLDS",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Jiing Ru Shieh
• Wei Y Shieh, M.D.
• Yiwey Shieh, M.D.
• Zohair Iftikhar Shiekh
• Brooke Emily Shields, LMSW
• Danielle Amber Shields
• Ellen M Shields, LCSW
• Jerry Francis Shields, M.D.
• John Shields, DPM
• Meredith Groff Shields, NP

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.