Individual provider Active NPI

Joel Dean Shields, RPH

  • Pharmacist
  • Pella, IA
National Provider Identifier
1023232097
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13515 Issued in IA
Practice address
1610 Vermeer Rd E
Pella, IA 50219-7658
Phone
(641) 621-7470
Fax
(641) 621-7471
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13515 IA Primary

Addresses

Primary practice location

1610 Vermeer Rd E
Pella, IA 50219-7658

Mailing address

1033 Howe St
Newton, IA 50208-9044
Phone (641) 792-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13515IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023232097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 HOWE ST",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502089044",
            "telephone_number": "641-792-8855",
            "fax_number": "641-792-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 VERMEER RD E",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502197658",
            "telephone_number": "641-621-7470",
            "fax_number": "641-621-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JOEL",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "13515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.