Mary Kathryn Shields, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9076 Issued in KY

Practice address

7808 Cliffs Edge CT
Louisville, KY 40241-1572

Phone

(386) 451-4131

NPI assigned

Sep 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1184907677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 CLIFFS EDGE CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411572",
            "telephone_number": "386-451-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 CLIFFS EDGE CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411572",
            "telephone_number": "386-451-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shields & Fidanza, LLC
• Christopher B Shields, MD
• Jaclyn Shields
• James Francis Shields, PSY.D
• Kayla Maria Shields, MD
• Whitney Danielle Shields, CRNA
• Tina Shier
• Catherine Rosati Shim, MD
• Deborah Shim, MD
• Ebony Shimin, LCSW

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.