Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Maalouf Shively, PA

Individual provider Physician Assistant · NPI 1023671617

Nicole Maalouf Shively, PA is a Physician Assistant in Roanoke, Virginia. Qualified in 2019, 7 years ago. Practices with Mcv Associated Physicians, a 1,767-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1622 Westover Ave SW
Roanoke, VA 24015-5216
Phone: (339) 368-1887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-10795 (NC)

Record details

NPI number1023671617
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 18, 2019
Last updated in NPPESJuly 31, 2024
Certification dateJuly 31, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice McV Associated Physicians — 1767 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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