Individual provider Active NPI

Keith D'Alton Shields, PA-C

  • Physician Assistant
  • Cumberland, RI
National Provider Identifier
1265972350
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
106 Nate Whipple Hwy Ste 101
Cumberland, RI 02864-1403
Phone
(401) 658-2020
Fax
(401) 658-3612
NPI assigned
Mar 8, 2017
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

106 Nate Whipple Hwy Ste 101
Cumberland, RI 02864-1403

Mailing address

106 Nate Whipple Hwy Ste 101
Cumberland, RI 02864-1403
Phone (401) 658-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190830002762 RI Practitioner - Physician Assistant 1254660160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers of Rhode Island PCGroup PAC ID 3072913714, 51 clinicians

Practice addresses (Care Compare)

106 Nate Whipple Hwy
Suite 101
Cumberland, RI 02864-1403
Phone (401) 658-2020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: keith.shields.1@31278.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1265972350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 NATE WHIPPLE HWY STE 101",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641403",
            "telephone_number": "401-658-2020",
            "fax_number": "401-658-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NATE WHIPPLE HWY STE 101",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641403",
            "telephone_number": "401-658-2020",
            "fax_number": "401-658-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "KEITH",
        "middle_name": "D'ALTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-08",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, RI

Sources for this page

Verify at the official NPI Registry.