Ian A Shields, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15078 Issued in MN

Practice address

2014 S 6TH St
Brainerd, MN 56401-4529

Phone

(218) 829-7812

NPI assigned

Feb 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Joseph'S Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
  • NPI 1568415974
  Medicare reassignment Care Compare group
• St Joseph'S Medical Center

  • Multi-Specialty Clinic/Center
  • Staples, MN
  • NPI 1538916101
  NPD
• St. Joseph'S Medical Center

  • General Practice Physician
  • Brainerd, MN
  • NPI 1184866956
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph'S Medical Center

  • General Practice Physician
  • Brainerd, MN
  • NPI 1184866956

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Anesthesiology Physician
  • Brainerd, MN
  • NPI 1336465038

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Crosslake, MN
  • NPI 1477509776

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Multi-Specialty Clinic/Center
  • Emily, MN
  • NPI 1538571914

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • General Acute Care Hospital
  • Brainerd, MN
  • NPI 1568415974
  Care Compare affiliation
• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Pierz, MN
  • NPI 1568418861

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Pine River, MN
  • NPI 1649223603

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Pequot Lakes, MN
  • NPI 1730134891

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brainerd, MN
  • NPI 1740393032

  Hospital

  Care Compare affiliation
• St. Joseph'S Medical Center

  • Primary Care Clinic/Center
  • Pillager, MN
  • NPI 1891740957

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1063913853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-829-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "IAN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Service Drug of Brainerd, Inc
• Claribel Severson, PHD, NCC, LPCC
• Katherine Severson, PHARMD
• Michael Severson
• Victoria Ann Severson, DDS
• Megan Lee Sibbert, MSW, LICSW
• Stephanie Silgjord, MSW, LICSW
• Denise Marie Sjodin, RN
• Susan Skarp, MD
• Laura J. Skogen, M.S.W.

• Physician Assistant in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.