NPIMap

Organization Active NPI

David a. Shields, D.C., P.C.

Doing business as depot chiropractor dr. shields

  • Chiropractor
  • Paoli, PA
National Provider Identifier
1790826253
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002446L Issued in PA
Legal business name
DAVID A. SHIELDS, D.C., P.C.
Doing business as
depot chiropractor dr. shields
Practice address
21 Plank Ave
Suite 108
Paoli, PA 19301-1785
Phone
(610) 644-6640
Fax
(610) 644-6641
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David A Shields, D.C.NPI 1972501468
Title
President for Life
Phone
(610) 644-6640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002446L PA Primary

Addresses

Primary practice location

21 Plank Ave
Suite 108
Paoli, PA 19301-1785

Mailing address

21 Plank Ave
Suite 108
Paoli, PA 19301-1785
Phone (610) 644-6640

Other identifiers 2

IdentifierTypeStateIssuer
0877346000OtherPABC GROUP NUMBER
0877346000OtherPAKHPE GROUP NUMBER

Other names 1

  • depot chiropractor dr. shields Doing business as

National Provider Directory

National Provider Directory

Locations

21 Plank Ave
Ste 108
Paoli, PA 19301
Phone (610) 644-6640

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790826253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PLANK AVE",
            "address_2": "SUITE 108",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011785",
            "telephone_number": "610-644-6640",
            "fax_number": "610-644-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PLANK AVE",
            "address_2": "SUITE 108",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011785",
            "telephone_number": "610-644-6640",
            "fax_number": "610-644-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A. SHIELDS, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT FOR LIFE",
        "authorized_official_telephone_number": "610-644-6640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002446L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP NUMBER",
            "identifier": "0877346000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE GROUP NUMBER",
            "identifier": "0877346000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "depot chiropractor dr. shields",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.