Individual provider Active NPI

George B. Shields, O.D.

  • Optometrist
  • Annapolis, MD
National Provider Identifier
1407952179
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1738 Issued in MD
Practice address
1905 Towne Centre Blvd
Annapolis, MD 21401-3594
Phone
(410) 268-8200
Fax
(410) 266-3996
NPI assigned
Sep 16, 2006
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1738 MD Primary

Addresses

Primary practice location

1905 Towne Centre Blvd
Annapolis, MD 21401-3594

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 4

IdentifierTypeStateIssuer
1316147184OtherGROUP NPI
1316229701OtherGROUP NPI
236068OtherPTAN
547POtherPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20080123000893 MD Practitioner - Optometry 1153419023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania State University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

2321 Forest Dr
Suite E
Annapolis, MD 21401-4679
Phone (410) 266-3369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1738MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Sep 15, 2018 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Sep 15, 2018 Accepting new patients
Joanne Brilliant O.D., P.a. Optometrist PastSince May 3, 1999 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients
Anchor Eyecare Optometrist Past Accepting new patients

Locations

1905 Towne Centre Blvd
Ste 110
Annapolis, MD 21401
Phone (410) 268-8200

2321 Forest Dr
Annapolis, MD 21401
Phone (410) 266-3369

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1407952179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 TOWNE CENTRE BLVD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013594",
            "telephone_number": "410-268-8200",
            "fax_number": "410-266-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "GEORGE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1316147184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1316229701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "236068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "547P",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.