Fallon Shields

Primary specialty

Social WorkerTaxonomy code 104100000X

License

20545 Issued in MD

Practice address

64 Industrial Park Rd # RS
Plymouth, MA 02360-4881

Phone

(508) 747-7094

NPI assigned

Jan 5, 2015

Last updated

Oct 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1811385586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 KNOWLES AVE STE 200",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD # RS",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "508-747-7094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3930 Knowles Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kensington",
            "state": "MD",
            "postal_code": "208952428",
            "country_code": "US",
            "telephone_number": "240-203-9161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "FALLON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "50080486",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "20545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiangyun Sheng, D.M.D
• Janet M Shepard, NP
• Shannon Marie Sheridan
• Christopher James Shestak, M.D.
• Mary Lou Shewchuk, LICSW
• Kerry Shotz, LMHC
• Julie Showalter, LADC I
• Logan Showstead
• Conrad Shultz, LADC
• Ashley Brooke Shute, MSW

• Social Worker in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.