Jeffrey Charles Shirts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M-15642 Issued in ID

Practice address

980 W Ironwood Dr Ste 302
Coeur D Alene, ID 83814-2668

Phone

(208) 292-5437

NPI assigned

Mar 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeside Pediatric & Adolescent Medicine, PLLC

  • Pediatric Adolescent Medicine Physician
  • Coeur D'Alene, ID
  • NPI 1003975087
  NPD (past)

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1821592254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR STE 302",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-292-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR STE 302",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142668",
            "telephone_number": "208-292-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653-1 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-224-3149",
            "fax_number": "904-244-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRTS",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M-15642",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "TRN27183",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN27183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Sherman
• Alexander Yowei Sheu, MD
• SHH Medical Group LLC (Autumn Ridge Medical Group)
• SHH Medical Group North Idaho, LLC (Autumn Ridge Medical Group)
• Bart Shields
• Jayne S Shoda, MSN, FNP-C
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 069)
• Shopko Stores Operating Co. LLC (ShopKo Optical 069)
• Shoptikal LLC (Shopko Optical 4069)
• Hayden Shultz

• Pediatrics Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Pediatrics Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.