SHIELDS SIGNATURE IMAGING, LLC (NPI# 1417320912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417320912 |
| Entity Type | Organization |
| Organization Name | SHIELDS SIGNATURE IMAGING, LLC |
| Practice Address |
680 Centre St Brockton MA 02302-3308 |
| Mailing Address |
55 Christy Dr Brockton MA 02301-1813 |
| Practice Telephone | 8662584738 |
| Mailing Telephone | 5088971501 |
| Mailing Fax Number | 5088971599 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2016-07-06 |
| Authorized Official Name | MR. JEFFREY RONNER (CFO) |
| Authorized Official Telephone | 6173767416 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SHIELDS SIGNATURE IMAGING, LLC | 700 Congress St. Ste. 204, Quincy, MA 02169 |
| Street Address |
680 CENTRE ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02302-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176910 | Marcia Waitzman | Obstetrics & Gynecology | 680 Centre St, Brockton, MA 02302-3308 | 2005-07-01 |
| 1770196396 | Samantha Lipsky | Physician Assistant | 680 Centre St, Brockton, MA 02302-3308 | 2020-08-24 |
| 1760009328 | Mandi Ella Clegg | Social Worker | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-30 |
| 1972128643 | Matthew Hall Wilson | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1679198493 | Alyssa Dicosmo | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-09 |
| 1720603566 | Tessie Allan | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1588289375 | Collin Rozanski | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1619592417 | Balaji Arun Jothishankar | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1013532845 | Angell Shi | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| 1386269124 | Rebecca Yanovsky | Student in an Organized Health Care Education/Training Program | 680 Centre St, Brockton, MA 02302-3308 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1578055505 | Steigmward Desir | Specialist | 472 E Ashland St, Brockton, MA 02302 | 2018-06-05 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700303856 | My Care, LLC | Home Health | 307 Field Street, Brockton, MA 02302 | 2017-08-29 |
| 1982124988 | Shavon Franks | Psychologist | 30 Downey Rd, Brockton, MA 02302 | 2017-06-21 |
| 1831629286 | Kings & Queens Empowered | Religious Nonmedical Health Care Institution | 312 Carl Ave, Brockton, MA 02302 | 2017-06-18 |
| 1487193389 | Roseline Eliezer | Licensed Practical Nurse | 17 Simeon Avenue, Brockton, MA 02302 | 2017-02-13 |
| 1184008989 | Danielle Parker | Student in an Organized Health Care Education/Training Program | 23 Grinnell Rd, Brockton, MA 02302 | 2015-07-13 |
| Find all providers in zip 02302 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679720379 | Steward Pet Imaging, L.L.C. | Clinic/Center | 235 North Pearl Street, Brockton, MA 02301-1794 | 2008-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081566 | Shields Pet-ct At Emerson Hospital LLC | Clinic/Center | 54 Baker Avenue Ext Ste 104, Concord, MA 01742-2137 | 2020-10-22 |
| 1437429305 | Northstar Imaging | Clinic/Center | 66 Dwight Rd, Suite 4, Longmeadow, MA 01106-1889 | 2012-01-09 |
| 1720313869 | M&tps Inc. | Clinic/Center | 5 Stub Toe Ln, Milford, MA 01757-1054 | 2009-10-07 |
| 1841447927 | Steward Pet Imaging, LLC | Clinic/Center | 735 Cambridge St, Brighton, MA 02135-2926 | 2008-08-20 |
| 1689623563 | Umass Memorial Mri & Imaging Center, LLC | Clinic/Center | 214 Shrewsbury St, Worcester, MA 01604-4629 | 2006-05-09 |
| 1558310474 | Baystate Mri & Imaging Center, LLC | Clinic/Center | 80 Wason Ave., Springfield, MA 01107-1119 | 2006-05-08 |
| 1487626644 | New England Mobile X-ray, Inc. | Clinic/Center | 3 Cabot Pl, Unit 9, Stoughton, MA 02072-4612 | 2006-02-02 |
| 1902421324 | Pdi Health Ma LLC | Clinic/Center | 1 Bridge St, Newton, MA 02458-1132 | 2020-06-11 |
| 1982165056 | Imaging Consultants Inc | Clinic/Center | 100 South St, Southbridge, MA 01550-4051 | 2019-03-29 |
| 1902367204 | Imaging Consultants Inc | Clinic/Center | 242 Green St, Gardner, MA 01440-1336 | 2019-03-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.