Active NPI
Nicholas Allen Shields, P.T.
- Physical Therapist
- Amarillo, TX
National Provider Identifier
1114238516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3109162
- Practice address
- 1619 South Kentucky St.
Amarillo, TX 79102 - Phone
- (806) 373-2200
- NPI assigned
- Jun 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3109162 | TX | Primary |
Addresses
Primary practice location
1619 South Kentucky St.
Amarillo, TX 79102
Mailing address
7550 Hillside
Apt. 719
Amarillo, TX 79119
Phone (817) 301-5990
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3109162 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1114238516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7550 HILLSIDE",
"address_2": "APT. 719",
"city": "AMARILLO",
"state": "TX",
"postal_code": "79119",
"telephone_number": "817-301-5990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 SOUTH KENTUCKY ST.",
"city": "AMARILLO",
"state": "TX",
"postal_code": "79102",
"telephone_number": "806-373-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "NICHOLAS",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-30",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "3109162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.