KERRIE A SHIVELY
NPI 1134051634
Counselor - Professional in Williamsburg, VA
About Kerrie A Shively NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KERRIE A SHIVELY (NPI 1134051634) is an individual professional provider in Williamsburg, Virginia, licensed in Virginia (0701016236) and active in the NPI registry since June 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
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)
Kerrie A Shively is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kerrie Shively reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Williamsburg, VA 23188
- Reassigned Medicare billing, Virginia enrollment
- 3 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WILLIAMSBURG, VA 23185
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 Kerrie Shively's NPI number?
The NPI number for Kerrie Shively is 1134051634. It was assigned to this individual provider in the NPPES registry on June 1, 2026.
Where is Kerrie Shively located?
Kerrie Shively practices at 1158 Professional Dr Ste G, Williamsburg, VA 23185. The listed phone number is (757) 349-6463.
What is Kerrie Shively's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kerrie Shively enrolled in Medicare?
Yes. Kerrie Shively is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kerrie Shively's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kerrie Shively reassigns Medicare benefits to Authentic Self Association LLC (Williamsburg, VA). The 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 Kerrie Shively's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kerrie Shively accept?
Health plans from Oscar Health list Kerrie Shively 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 Kerrie Shively was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Kerrie A Shively · NPI 1134051634
Professional provider in Williamsburg, Virginia. Individual provider, active in the CMS NPPES registry since June 1, 2026.
## Identity
- **NPI:** 1134051634 (Entity type: Individual)
- **Enumerated:** June 1, 2026
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 0701016236 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1158 PROFESSIONAL DR STE G, Williamsburg, VA 23185-6618
- **Phone:** (757) 349-6463
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Authentic Self Association LLC (NPI 1720854466, Williamsburg, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** June 1, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1134051634) · Data from the CMS NPPES public registry.