Justin L. Shields MD PA

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME45060 Issued in FL

Legal business name

JUSTIN L. SHIELDS MD PA

Practice address

540 Fontaine St
Pensacola, FL 32503-2019

Phone

(850) 484-4775

Fax

(850) 484-8223

NPI assigned

Jul 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin L Shields, M.D.NPI 1255359386

Title

President

Phone

(850) 380-0481

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin L Shields III, M.D.

  • MOHS-Micrographic Surgery Physician
  • Pensacola, FL
  • NPI 1255359386
  Authorized official Same address or phone

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114951449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1555",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325621555",
            "telephone_number": "850-484-4775",
            "fax_number": "850-484-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 FONTAINE ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032019",
            "telephone_number": "850-484-4775",
            "fax_number": "850-484-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN L. SHIELDS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-380-0481",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME45060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathrine M Judycki, PHARMD
• Junior Foods Stores of West Flordia Inc (Kroger Pharmacy #125)
• Just Companion Care LLC
• Brittany Justice, ARNP
• Kelly Meek Justice, PH.D.
• Ka'Dira Carey (Trusted Coneections Therapeutic Services)
• Sonja Ann Kabella, COTA
• Patricia Kachur
• Sergey Kachur, M.D.
• Korin Kaczocha, DDS

• MOHS-Micrographic Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.