Russell B Shields MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RUSSELL B SHIELDS MD PC

Practice address

425 Medical Dr
Ste 108
Bountiful, UT 84010-4945

Phone

(801) 292-8444

Fax

(801) 292-8476

NPI assigned

Oct 24, 2005

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell Brent ShieldsNPI 1568451730

Title

President

Phone

(801) 292-8444

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Russell Brent Shields, MD

  • Internal Medicine Physician
  • Bountiful, UT
  • NPI 1568451730
  Authorized official Same address or phone

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1477543213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DR",
            "address_2": "STE 108",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104945",
            "telephone_number": "801-292-8444",
            "fax_number": "801-292-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DR",
            "address_2": "STE 108",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104945",
            "telephone_number": "801-292-8444",
            "fax_number": "801-292-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL B SHIELDS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-292-8444"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Fernanda Rubilar Vasquez, STUDENT
• Allyson White Rucker, NP
• Adam Barry Rudd, O.D.
• Michelle Rusch
• Mia Rushton
• Mary Melinda Russell-Stamp, PHD
• Milton Russon
• Ryan K Anderson D P M P C (Foot & Ankle Specialists of Utah)
• David Nathaniel Arthur Ryan, D.O.
• Emilie Kara Ryan

• Family Medicine Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.