DIANA SHIELDS (ARNP) – Family Nurse Practitioner, NPI 1154210813

DIANA SHIELDS (ARNP) is a healthcare provider. based in Longview, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. AP70024360 (WA). The NPI Number for DIANA SHIELDS (ARNP) is 1154210813

Main info

Female
1 Year Of Experience
Name
DIANA SHIELDS (ARNP)
NPI
1154210813
Phone
(360) 636-3892
Address
1057 12TH AVE
Enumeration Date
30 June 2025
Last Update Date
25 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3606363892
Graduation Year
2025 (1 year ago)
PAC ID
2163912957
Group Practice PAC ID
5991696395
Professional Enrollment ID
I20251110001937
Address ID
WA986322509LO1057XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for DIANA SHIELDS (ARNP)

  • 1057 12TH AVE

    LONGVIEW, WA 986322509

    Phone: (360) 636-3892

    Fax: (360) 414-1342

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251110001937INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98632)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991696395View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Family PracticeWA
Nurse PractitionerWA
-WA
Nurse PractitionerOR
Family PracticeWA

Reviews

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Frequently asked questions

Can I use this page to confirm DIANA SHIELDS (ARNP)'s NPI?
Yes. DIANA SHIELDS (ARNP) is listed with NPI 1154210813 in the public NPI dataset.
Is DIANA SHIELDS (ARNP) still practicing?
DIANA SHIELDS (ARNP) is currently listed as active in the public NPI registry.
What taxonomy line describes DIANA SHIELDS (ARNP)?
For research purposes, treat DIANA SHIELDS (ARNP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does DIANA SHIELDS (ARNP) serve?
DIANA SHIELDS (ARNP)'s listing highlights Longview, Washington; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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