Individual provider Active NPI

Daniel Shields, DO

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1235664095
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS17204 Issued in FL
Practice address
2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone
(561) 420-8555
Fax
(561) 420-8550
NPI assigned
Apr 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS17204 FL Primary

Addresses

Primary practice location

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501

Mailing address

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

Other practice location 1

7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone (918) 710-4200

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS17204FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St John Urgent Care Clinics Inc Past Accepting new patients
St. John Physicians, Inc. Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1235664095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-420-8555",
            "fax_number": "561-420-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-420-8555",
            "fax_number": "561-420-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7501 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741365056",
            "country_code": "US",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS17204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.