Active NPI
Courtney Shields
- Counselor
- Pelham, AL
National Provider Identifier
1376906743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C2617A
- Practice address
- 2172 Pelham Pkwy
Suite 104
Pelham, AL 35124-1118 - Phone
- (205) 617-8801
- NPI assigned
- Apr 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C2617A | AL | Primary |
Addresses
Primary practice location
2172 Pelham Pkwy
Suite 104
Pelham, AL 35124-1118
Mailing address
2172 Pelham Pkwy
Suite 104
Pelham, AL 35124-1118
Phone (205) 617-8801
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2617A | AL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1376906743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2172 PELHAM PKWY",
"address_2": "SUITE 104",
"city": "PELHAM",
"state": "AL",
"postal_code": "351241118",
"telephone_number": "205-617-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2172 PELHAM PKWY",
"address_2": "SUITE 104",
"city": "PELHAM",
"state": "AL",
"postal_code": "351241118",
"telephone_number": "205-617-8801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "COURTNEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-01",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "C2617A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pelham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.