NPIMap

Individual provider Active NPI

Roderick A Shields, MD

  • Family Medicine Physician
  • Florence, MS
National Provider Identifier
1760436570
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12884 Issued in MS
Practice address
128 Earl Clark Dr
Florence, MS 39073-6604
Phone
(601) 891-8465
Fax
(601) 891-8468
NPI assigned
May 19, 2006
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12884 MS Primary

Addresses

Primary practice location

128 Earl Clark Dr
Florence, MS 39073-6604

Mailing address

PO Box 1188
Florence, MS 39073-1188
Phone (601) 891-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000425 MS Practitioner - Family Practice 1557323177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

128 Earl Clark Dr
Florence, MS 39073-6604
Phone (601) 891-8465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.77 of 100Reported as individual
Quality
97.74
Improvement activities
40
Cost
75.58

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue11
Skin biopsy31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Rankin Family Clinic, LLC Family Medicine CurrentSince Jan 1, 2007 Accepting new patients
River Oaks Management Company LLC Family Medicine Past Accepting new patients

Locations

128 Earl Clark Dr
Florence, MS 39073
Phone (601) 891-8465

368 Scarbrough St
Ste B
Richland, MS 39218
Phone (601) 664-2273

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFCAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFCAA/Endpoint/IAFCAA

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1760436570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390731188",
            "telephone_number": "601-891-8465",
            "fax_number": "601-891-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 EARL CLARK DR",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390736604",
            "telephone_number": "601-891-8465",
            "fax_number": "601-891-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "RODERICK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "12884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, MS

Sources for this page

Verify at the official NPI Registry.