Alonzo Jamelle Shields, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

7244689 Issued in AL

Practice address

Regimental Aid Station
7TH Marine HQ Ras
Twentynine Palms, CA 92278

Phone

(334) 370-7078

NPI assigned

Sep 18, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1013267996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 788-260",
            "address_2": "2ND MARINE REGIMENT STATION",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788266",
            "telephone_number": "334-370-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REGIMENTAL AID STATION",
            "address_2": "7TH MARINE HQ RAS",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "334-370-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "ALONZO",
        "middle_name": "JAMELLE",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "AL",
            "license": "7244689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean R Thomas MD, Inc
• Emily Rose Sebald, LCSW
• Patricia A Sena-Bolding, PT
• Kirra Irene Senne, MMS, PA-C
• Maria T Sheldrake, O.D.
• Christopher Masaki Shimizu, DDS
• Supinda Sirihekaphong
• Courtney Nicole Smith, IDC
• Rachel Smith, RD
• William Smith III, DC

• Independent Duty Corpsman in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.