Kallie Shafer, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP012633 Issued in PA

Practice address

1370 Washington Pike Ste 107
Bridgeville, PA 15017-2889

Phone

(412) 221-0160

NPI assigned

Dec 18, 2012

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

• Kallie Rose Hall 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: kshafer740287@direct.ahn.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allegheny Clinic Pediatrics

  • Pediatrics Physician
  • Carnegie, PA
  • NPI 1326436619
  NPD (past)
• Children'S Community Care

  • Pediatrics Physician
  • Pittsburgh, PA
  • NPI 1942217567
  NPD (past)
• Childrens Community Pediatrics

  • Pediatrics Physician
  • Monroeville, PA
  • NPI 1740244110
  NPD (past)

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1891031928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 WASHINGTON PIKE STE 107",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150172889",
            "telephone_number": "412-221-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 WASHINGTON PIKE STE 107",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150172889",
            "telephone_number": "412-221-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "KALLIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "SP012633",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP012633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALLIE",
            "last_name": "HALL",
            "middle_name": "ROSE",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stacie Sebastian, LPC
• Jacob Michael Sebastiao, PHARMD
• Barbara Senatore, LSW
• Serenity Care, Inc,
• Alin J Severance, M.D.
• Muhammad Ilyas Shaikh, MD
• Sumiyah Shaikh, PA-C
• Madison Shaner, LPC
• Abby Sharrer
• Amy W Shelhamer, OTR

• Pediatric Nurse Practitioner in Bridgeville, PA
• Providers in Bridgeville, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.