John Mendell Shields, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY 13804 Issued in CA

Practice address

211 Main St
Goshen, NY 10924-2191

Phone

(415) 706-7626

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1801936406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MONTGOMERY ST",
            "address_2": "SUITE 1020",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941042902",
            "telephone_number": "415-434-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MAIN ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242191",
            "telephone_number": "415-706-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JOHN",
        "middle_name": "MENDELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "22988",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY 13804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Shedrick, COTA
• Eileen Shen, CCC, SLP
• Robin Sherwin, LCSW
• Viral Ras Sheth, MD
• Deborah Margaret Shields, LCSW
• Kathleen Shine, RN
• Amanda L Shirk-Manner, MS, CCC-SLP
• Sheila M Shormis
• Sofya Shuster, PH.D.
• Lance M Siegel, M.D.

• Forensic Psychologist in Goshen, NY
• Providers in Goshen, NY by specialty
• Forensic Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.