Justin L Shields III, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME45060 Issued in FL

Practice address

540 Fontaine St
Pensacola, FL 32503-2019

Phone

(850) 484-4775

Fax

(850) 484-4775

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255359386",
    "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": "850-484-4775"
        },
        {
            "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": "850-484-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JUSTIN",
        "middle_name": "L",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME45060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Sheridan, OTR, CHT
• K M Sheridan, M.D.
• Wesley Adam Sherouse, D.M.D
• James Sherrard, MS, RD, CHES
• Victor Thomas Sherrel, M.D,
• Angelo Hideo Shimada, OD
• Caron Shimel, LCSW
• Esther Shin, DO
• Ashley Michelle Shipley, RN, BSN, RBT
• Lauren Shipman, ATC, LAT, CBOE

• 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 Jul 8, 2007; 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.