KELLY A SHIELDS LPC
NPI 1083075790
Counselor - Professional in Portland, OR
About Kelly A Shields Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY A SHIELDS LPC (NPI 1083075790) is an individual professional provider in Portland, Oregon, licensed in Oregon (C3406) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly A Shields Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Kelly Shields reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 676 clinicians in this Medicare group
Portland, OR 97225
- Reassigned Medicare billing, Oregon enrollment
- 753 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
PORTLAND, OR 97213
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Shields's NPI number?
The NPI number for Kelly Shields is 1083075790. It was assigned to this individual provider in the NPPES registry on March 9, 2016. The provider is also known as Kelly Shields-Didehbani Lpc.
Where is Kelly Shields located?
Kelly Shields practices at 5228 NE Hoyt St, Portland, OR 97213. The listed phone number is (503) 215-6474.
What is Kelly Shields's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kelly Shields enrolled in Medicare?
Yes. Kelly Shields is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelly Shields's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Shields reassigns Medicare benefits to 2 organizations: Providence Health & Services - Oregon (Portland, OR) and Providence Health & Services - Oregon (Portland, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Shields's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Shields accept?
Health plans from Providence Health Plan list Kelly Shields as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Shields was last updated on January 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly A Shields, LPC · NPI 1083075790
Professional provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 9, 2016.
## Identity
- **NPI:** 1083075790 (Entity type: Individual)
- **Enumerated:** March 9, 2016
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** C3406 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 5228 NE HOYT ST, Portland, OR 97213-3055
- **Phone:** (503) 215-6474
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Providence Health & Services - Oregon (NPI 1003991845, Portland, OR); Providence Health & Services - Oregon (NPI 1235259532, Portland, OR) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083075790) · Data from the CMS NPPES public registry.