Gary N Shields, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000820 Issued in CT

Practice address

340 Bantam Rd
Suite 1-B
Litchfield, CT 06759-3318

Phone

(860) 567-1600

Fax

(860) 567-1606

NPI assigned

Jul 24, 2006

Last updated

Jul 28, 2009By the provider in NPPES

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

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Atlantic Podiatry Associates DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Daytona Beach, FL
  • NPI 1154349082
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1073535456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741240",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327741240",
            "telephone_number": "386-774-5211",
            "fax_number": "386-774-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BANTAM RD",
            "address_2": "SUITE 1-B",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "067593318",
            "telephone_number": "860-567-1600",
            "fax_number": "860-567-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "GARY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CINGA",
            "identifier": "6240129",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041318600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA DME",
            "identifier": "261444569",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "6145090001",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003499",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "614459",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Monty Sabolcik Sr., LCSW
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• Rosalie A Sheridan-Guest, LPC
• Sherman Hill Counseling & Therapy Center, LLC
• Steven Sideris, DDS
• Tommasina Pasqua Sideris, OD
• John Paul Simoncelli, DDS
• John Wedge Simoncelli, L.C.S.W, L.A.D.C
• Diane Lee Sisson, LCSW

• Podiatrist in Litchfield, CT
• Providers in Litchfield, CT by specialty
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.