BRADLEY KEITH SHIELDS (NPI# 1073086005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073086005 |
| Entity Type | Individual |
| Full Name | BRADLEY KEITH SHIELDS |
| Practice Address |
128 Earl Clark Dr Florence MS 39073-6604 |
| Practice Telephone | 6018918465 |
| Practice Fax Number | 6018918468 |
| Mailing Telephone | 6018918465 |
| Mailing Fax Number | 6018918468 |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 903096 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956835 | Bradley Douglas Shields | Student in an Organized Health Care Education/Training Program | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2020-06-10 |
| Street Address |
128 EARL CLARK DR |
| City | FLORENCE |
| State | MS |
| Zip Code | 39073-6604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760436570 | Roderick A Shields | Family Medicine | 128 Earl Clark Dr, Florence, MS 39073-6604 | 2006-05-19 |
| 1699022392 | Cindy Shields Dean | Nurse Practitioner | 128 Earl Clark Dr, Florence, MS 39073-6604 | 2012-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497295117 | Eletha Walker | Massage Therapist | 215 Walker Smith Rd, Florence, MS 39073 | 2017-02-28 |
| 1154691004 | Freds Stores of Tennessee Inc | Pharmacy | 2932 Hwy 49 S., Florence, MS 39073 | 2012-01-10 |
| 1538330444 | Florence Dental Clinic | Dentist | 129 Earl Clark Drive, Florence, MS 39073 | 2008-03-19 |
| 1548323579 | Thomas Raymond Byrd | Dentist | 129 Earl Clark Dr., Florence, MS 39073 | 2006-12-19 |
| 1841384443 | Kelley N Martin | Nurse Practitioner | 218 East Main Street, Florence, MS 39073 | 2006-10-03 |
| 1851484422 | Derek Wade Puckett | Physical Therapist | 3000 Hwy 49 South, Florence, MS 39073 | 2006-10-02 |
| 1508961947 | Polks Discount Drugs #2 | Pharmacy | 101 49 Place, Florence, MS 39073 | 2006-09-13 |
| 1669652558 | Martin Health Care, LLC | Family Medicine | 218 East Main St, Florence, MS 39073-0530 | 2007-11-07 |
| 1245415645 | Emmanuel Ridge Community Service Organization | Clinic/Center | 2073 Hwy 49 South, Florence, MS 39073-1944 | 2008-01-03 |
| 1235314634 | Emmanuel Ridge Home Care Agency Inc | Non-emergency Medical Transport (VAN) | 2073 Hwy 49 South, Florence, MS 39073-1944 | 2008-01-03 |
| Find all providers in zip 39073 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407467038 | Marcus Tedder | Nurse Practitioner | 1005 E Cheves St Ste 100, Florence, SC 29506-2707 | 2020-08-17 |
| 1508498015 | Jessy Krallum | Nurse Practitioner | 731 Coventry Ln Apt A, Florence, SC 29501-8867 | 2020-02-12 |
| 1689175408 | Machelle Speicher Smith | Nurse Practitioner | 4213 Byrnes Blvd, Florence, SC 29506-8335 | 2018-02-27 |
| 1427560697 | Marie Nicole Sartori | Nurse Practitioner | 7766 Ewing Blvd Ste 100, Florence, KY 41042 | 2017-10-27 |
| 1083156350 | Karen Artis-bacote | Nurse Practitioner | 3835 Susan Dr, Florence, SC 29501 | 2016-11-17 |
| 1306394937 | Mary Austin | Nurse Practitioner | 7766 Ewing Boulevard, Florence, KY 41042 | 2016-09-12 |
| 1437531993 | Sherika Tarshall Stuckey | Nurse Practitioner | 720 Coventry Lane, Apt C, Florence, SC 29501 | 2015-06-22 |
| 1528316726 | Tri-state Pain Management Service Inc | Nurse Practitioner | 7370 Turfway Rd Ste 290, Florence, KY 41042-4896 | 2012-08-17 |
| 1780963066 | Rebecca Jane Ferguson | Nurse Practitioner | 2908 Mall Drive, Florence, AL 35630-1534 | 2011-08-04 |
| 1356645394 | Sonia Marie Campbell | Nurse Practitioner | 2268 Blass Dr, Florence, SC 29505-6479 | 2011-01-05 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.