DR. TED SHIELDS (NPI# 1972666147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972666147 |
| Entity Type | Individual |
| Full Name | DR. TED SHIELDS |
| Other Name | DR. TEDDY DOUGLAS SHIELDS |
| Credential | D.O. |
| Practice Address |
1710 Mayfield Drive Jonesboro AR 72401 |
| Mailing Address |
1710 Harrison St Batesville AR 72501-7303 |
| Practice Telephone | 8442150731 |
| Practice Fax Number | 8886308885 |
| Mailing Telephone | 8702621200 |
| Mailing Fax Number | 8702626088 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
E3420 | AR | Allopathic & Osteopathic Physicians |
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
E3420 | AR | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
E3420 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 148797003 | 05 | |
| AR | STATE LICENSE | E3420 | 01 |
| Street Address |
1710 MAYFIELD DRIVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699781427 | Sunil Gera | Pain Medicine | 2601 Southwest Square, Jonesboro, AR 72401 | 2006-08-01 |
| 1235300765 | Northeast Arkansas Pain Medicine | Pain Medicine | 505 E Matthews Ave, Suite 103, Jonesboro, AR 72401-3144 | 2008-03-12 |
| 1801976956 | Calin A Savu | Pain Medicine | 505 E Matthews Ave, Suite 103, Jonesboro, AR 72401-3144 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1932619327 | Fort Neuro | Pain Medicine | 1501 S Waldron Rd Ste 109, Fort Smith, AR 72903-2568 | 2017-10-11 |
| 1891061040 | Vadim Petrov-kondratov | Pain Medicine | 180 Medical Park Pl Ste 102, Hot Springs, AR 71901-8066 | 2012-03-31 |
| 1356635486 | Mohamed Tolba | Pain Medicine | 1080 Pats Ln, Conway, AR 72032-4754 | 2011-06-06 |
| 1295032407 | Interventional Pain Specialists of Nwa, Pllc | Pain Medicine | 509 E Millsap Rd Ste 109, Fayetteville, AR 72703-4862 | 2011-02-24 |
| 1376733824 | Hot Springs Interventional Pain Management | Pain Medicine | 1 Mercy Ln Ste 304, Hot Springs, AR 71913 | 2007-07-31 |
| 1558447599 | White River Health System, Inc. | Pain Medicine | 1700 Harrison St Ste T, Batesville, AR 72501-7315 | 2006-10-31 |
| 1104806702 | Robert David Cannon | Pain Medicine | 3715 N Business Dr, Suite #101, Fayetteville, AR 72703-5204 | 2006-01-19 |
| 1386641520 | Sunder Krishnan | Pain Medicine | 14918 Cantrell Rd, Little Rock, AR 72223-4248 | 2005-07-01 |
| 1568465698 | Donald L Boos Jr. | Pain Medicine | 307 Carpenter Dam Rd Ste F, Hot Springs, AR 71901-8282 | 2005-05-23 |
| Find all providers with the same taxonomy | ||||
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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.