Individual provider Active NPI

Kristen Shaver

  • Women's Health Nurse Practitioner
  • Statesville, NC
National Provider Identifier
1972174712
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SHAV-FO9W2 Issued in NC
Practice address
1420 Fern Creek Dr
Statesville, NC 28625-9376
Phone
(704) 380-3722
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5015307 NC
Women's Health Nurse Practitioner 363LW0102X SHAV-FO9W2 NC Primary

Addresses

Primary practice location

1420 Fern Creek Dr
Statesville, NC 28625-9376

Mailing address

134 Current Rd
Olin, NC 28660-8909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230417002631 NC Practitioner - Nurse Practitioner 7315312774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natural Beginnings Birth and Wellness CenterGroup PAC ID 4880840024, 3 clinicians

Practice addresses (Care Compare)

1420 Fern Creek Dr
Statesville, NC 28625-9376
Phone (704) 380-3722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5015307NCMDObstetrics & Gynecology Physician
SHAV-FO9W2NCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Beginnings Birth and Wellness Center Obstetrics & Gynecology CurrentSince Dec 9, 2022 Accepting new patients

Locations

1420 Fern Creek Dr
Statesville, NC 28625
Phone (704) 380-3722

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1972174712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 CURRENT RD",
            "city": "OLIN",
            "state": "NC",
            "postal_code": "286608909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-380-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVER",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "5015307",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "SHAV-FO9W2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.