Jak Shields, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

JAK SHIELDS, LLC

Doing business as

Montana Rx Compounders

Practice address

111 N Higgins Ave Ste 5
Missoula, MT 59802-4494

Phone

(406) 542-2888

Fax

(406) 542-9380

NPI assigned

Dec 21, 2021

Last updated

Mar 8, 2023By 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

Kelly Marie Shields, PHARM.DNPI 1528257474

Title

Owner/Pic

Phone

(406) 542-2888

Specialties & licenses 2

Addresses

Other names 1

• Montana Rx Compounders Doing business as

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.

• Kelly Marie Shields, PHARM.D.

  • Pharmacist
  • Missoula, MT
  • NPI 1528257474
  NPD Authorized official

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1669132379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N HIGGINS AVE STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024437",
            "telephone_number": "406-542-2888",
            "fax_number": "406-542-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HIGGINS AVE STE 5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024494",
            "telephone_number": "406-542-2888",
            "fax_number": "406-542-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAK SHIELDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "406-542-2888",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montana Rx Compounders",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montana Rx Compounders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler William Jacobsen, MD
• Barbara Ann Jacobson, FNP
• Jacy Jacobson
• Justin A. Jacobson, M.D.
• Jaime Jacoby
• Matthew Jakupcak, PHD
• James M Summers, DO & Associates PC
• Jeanine Renee James, DPT
• Jonathon James, D.O.
• Jamie Stocker LCPC, Atr, PLLC

• Compounding Pharmacy in Missoula, MT
• Providers in Missoula, MT by specialty
• Compounding Pharmacy in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.