JUSTIN L SHIELDS (NPI# 1730471368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730471368 |
Entity Type | Individual |
Full Name | JUSTIN L SHIELDS |
Credential | PA |
Practice Address |
25 Michigan St Ne Ste 5100 Grand Rapids MI 49503-2572 |
Mailing Address |
100 Michigan St Ne Mc-845 Grand Rapids MI 49503-2560 |
Practice Telephone | 6162670800 |
Practice Fax Number | 6162670801 |
Mailing Telephone | 6162670800 |
Mailing Fax Number | 6162670801 |
Enumeration Date | 2011-05-16 |
Last Update Date | 2015-10-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
Y | 363A00000X | Physician Assistant | 5601006017 | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 1730471368 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205247582 | Justin Shields | Specialist | 307 E Ovilla Rd, Suite # 100, Red Oak, TX 75154-3898 | 2014-05-08 |
1750571600 | Justin Cordell Shields | Anesthesiology | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2007-07-26 |
1972703460 | Justin Shields | Psychiatry & Neurology | Madigan Army Medical Ctr, 9040 A Reid St. Dept of Medicine, Tacoma, WA 98431-0001 | 2007-07-23 |
1255359386 | Justin L Shields IIi | Dermatology | 540 Fontaine St, Pensacola, FL 32503-2019 | 2006-07-17 |
Street Address |
25 MICHIGAN ST NE STE 5100 |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49503-2572 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871112276 | Alexis Meelker | Student in an Organized Health Care Education/Training Program | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2020-04-15 |
1598384620 | Craig Matisoff | Student in an Organized Health Care Education/Training Program | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2020-04-09 |
1376171439 | Cody Voss | Student in an Organized Health Care Education/Training Program | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2020-04-01 |
1720640741 | Chloe Leeann Balanda | Family Medicine | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2019-06-29 |
1235791328 | Joel Tyler Wood | Family Medicine | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2019-06-28 |
1114589280 | Billy Chu-li Hsu | Family Medicine | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2019-06-28 |
1275983835 | Brian Christopher Wilder | Family Medicine | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2016-06-15 |
1477911865 | Quiana Scott | Nurse Practitioner | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2016-02-01 |
1215341458 | Benjamin Brand Davidson | Family Medicine | 25 Michigan St Ne Ste 5100, Grand Rapids, MI 49503-2572 | 2014-06-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
Find all providers in zip 49503 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609473198 | Rachel M. Graziano | Physician Assistant | 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 | 2020-10-07 |
1811537269 | Joseph Salvatore Giovannucci | Physician Assistant | 145 Michigan St Ne Ste 2230, Grand Rapids, MI 49503-2562 | 2020-01-14 |
1326685686 | Mitchell Lebel | Physician Assistant | 932 Fulton St E Unit 1, Grand Rapids, MI 49503-3565 | 2019-12-05 |
1326680331 | Emily Wallace | Physician Assistant | 1661 Philadelphia Ave Se, Grand Rapids, MI 49507-2251 | 2019-10-10 |
1124688197 | Leeann Marie Kuehn | Physician Assistant | 218 Warren Ave Se, Grand Rapids, MI 49506-1582 | 2019-06-20 |
1770057549 | Shelby Elizabeth Hunt | Physician Assistant | 100 Michigan St Ne # Mc9017, Grand Rapids, MI 49503-2560 | 2019-01-15 |
1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
1174029094 | Katrina Ann Brummel | Physician Assistant | 555 Midtowne St Ne Ste 110, Grand Rapids, MI 49503-5731 | 2018-03-30 |
1902312994 | Aaron Michaud | Physician Assistant | 301 Barclay Ave Ne, Grand Rapids, MI 49503 | 2017-12-28 |
1538687215 | Sonia Nicola | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2017-09-01 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49503 |
Please comment or provide details below to improve the information on JUSTIN L SHIELDS.
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.