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Khadine Kenesha Shields , RN

Licensed Practical Nurse β€’ Brooklyn, NY

Active NPI 1982920674 Individual Practitioner Female Practitioner
Practice location in NPPES

161 Woodruff Ave, Apt.1a
Brooklyn, NY 112261870

Call 3472406232 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

161 Woodruff Ave
Apt.1a

Brooklyn, NY 112261870

Telephone 3472406232

NPI first issued

2010

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Brooklyn and New York

2,514 active clinicians are listed under Licensed Practical Nurse with a practice address in Brooklyn, NY (22,990 in New York).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Brooklyn

0% of these 2,514 clinicians have the CMS telehealth indicator.

0% of these 2,514 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-05
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES NY 300077

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New York Office of the Professions.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Business Mailing Address June 05, 2026

Registered at 67 SOUTHRIDGE DRIVE, WATERBURY, CT 06708 (Tel: 3475648227)

πŸ‘€
Provider Name / Credentials Updated June 05, 2026

Recorded as KHADINE SHIELDS, RN

βœ…
NPI Profile Active April 20, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 20, 2010

Registered at 161 WOODRUFF AVE, APT.1A, BROOKLYN, NY 112261870 (Tel: 3472406232)

πŸ“
Business Mailing Address (Initial Record) April 20, 2010

Registered at 161 WOODRUFF AVE, APT.1A, BROOKLYN, NY 112261870 (Tel: 3472406232)

πŸ‘€
Provider Name / Credentials (Initial Record) April 20, 2010

Recorded as KHADINE SHIELDS, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 20, 2010

Licensed Practical Nurse (license number reported to NPPES: NY 300077)

🟒
Initial NPI Registration & Enumeration April 20, 2010

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1982920674
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 20, 2010
Last Update: June 05, 2026
Sole Proprietor: Yes

Mailing Address

67 Southridge Drive

Waterbury, CT 06708

Phone: 3475648227

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.