Individual provider Active NPI

Nicole Jo Shields, WHNP-BC

  • Women's Health Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1982303764
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2024013769 Issued in MO
Practice address
1020 Hitt St
Columbia, MO 65212-0001
Phone
(573) 499-6084
Fax
(573) 499-6088
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2024013769 MO Primary

Addresses

Primary practice location

1020 Hitt St
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240627002865 MO Practitioner - Nurse Practitioner 8426592742 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
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

1020 Hitt St
Columbia, MO 65212-0001
Phone (573) 884-7100

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024013769MOMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Jun 3, 2024 Accepting new patients
Curators of the University of Missouri CurrentSince Jun 3, 2024 Accepting new patients

Locations

1020 Hitt St
Columbia, MO 65212
Phone (573) 882-6921

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1982303764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HITT ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-499-6084",
            "fax_number": "573-499-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "NICOLE",
        "middle_name": "JO",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2024013769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "1020 Hitt St",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.