Active NPI
Stephen J Shields MD PA
- Internal Medicine Physician
- Clearwater, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME53720
- Legal business name
- STEPHEN J SHIELDS MD PA
- Practice address
- 1211 Reynolds Ave
Suite B
Clearwater, FL 33756-3353 - Phone
- (727) 466-6564
- NPI assigned
- Oct 3, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stephen Joseph Shields
- Title
- Physician
- Phone
- (727) 466-6564
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME53720 | FL | Primary |
Addresses
Primary practice location
1211 Reynolds Ave
Suite B
Clearwater, FL 33756-3353
Mailing address
1211 Reynolds Ave
Suite B
Clearwater, FL 33756-3353
Phone (727) 466-6564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0946056 | Stephen J Shields MD PA | Certificate of waiver | May 17, 2028 |
National Provider Directory
National Provider DirectoryLocations
1211 Reynolds Ave
Ste B
Clearwater, FL 33756
Phone (727) 466-6564
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JHAJAA
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Clearwater, FL
- NPI 1427018506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1222992000000",
"number": "1962653394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 REYNOLDS AVE",
"address_2": "SUITE B",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337563353",
"telephone_number": "727-466-6564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 REYNOLDS AVE",
"address_2": "SUITE B",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337563353",
"telephone_number": "727-466-6564"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STEPHEN J SHIELDS MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-03",
"last_updated": "2008-10-03",
"status": "A",
"authorized_official_last_name": "SHIELDS",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "727-466-6564",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME53720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.