NPIMap

Organization Active NPI

Paris C Shields LLC

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1417300690
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW005676 Issued in GA
Legal business name
PARIS C SHIELDS LLC
Practice address
3354 Greystone Way
Valdosta, GA 31605-1096
Phone
(229) 241-7883
Fax
(229) 241-7479
NPI assigned
Jul 22, 2016
Last updated
Jul 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Authorized official

Name
Paris C Shields, LCSWNPI 1114270436
Title
Owner
Phone
(229) 241-7883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW005676 GA Primary

Addresses

Primary practice location

3354 Greystone Way
Valdosta, GA 31605-1096

Mailing address

3354 Greystone Way
Valdosta, GA 31605-1096
Phone (229) 241-7883

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160826000937 GA Part B Supplier - Clinic/Group Practice 7012202278 Receives reassigned benefits from 1 practitioner
Practice locations: Valdosta, GA

National Provider Directory

National Provider Directory

Locations

100 N Patterson St
#94
Valdosta, GA 31601
Phone (229) 300-7501

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1417300690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 GREYSTONE WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051096",
            "telephone_number": "229-241-7883",
            "fax_number": "229-241-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 GREYSTONE WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051096",
            "telephone_number": "229-241-7883",
            "fax_number": "229-241-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARIS C SHIELDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "PARIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-241-7883",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.