Katherine V Shield

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ML60863372 Issued in WA

Practice address

931 S. Market Blvd
931 S. Market Blvd
Chehalis, WA 98532

Phone

(360) 767-6300

NPI assigned

May 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Katherine V McNulty Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1760971550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHEHALIS FAMILY MEDICINE",
            "address_2": "931 S. MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-767-6300",
            "fax_number": "360-767-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 S. MARKET BLVD",
            "address_2": "931 S. MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-767-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELD",
        "first_name": "KATHERINE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML60863372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MCNULTY",
            "middle_name": "V",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristeen L Seratt, ARNP
• Brett Michael Shaffer, M.D.
• Anthony Curtis Shaw
• Diana Lynn Shay, LPN
• Todd Michael Shelton, D.C.
• Angela Marie Shimoda, MD
• James Raymond Shogreen, SUDPT
• A. Ellen Silas, LMP
• Radhika Sitapara, PHARM D
• Zachrey Skelly, PHARMD

• Family Medicine Physician in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.