BRADLEY KEITH SHIELDS
NPI 1073086005
Nurse Practitioner in Florence, MS

Active since January 02, 2019PECOS Enrolled
128 EARL CLARK DR, FLORENCE, MS 39073(601) 891-8465(601) 891-8468 Get Directions Write a Review

NPPES record last updated: January 2, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bradley Keith Shields NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY KEITH SHIELDS (NPI 1073086005) is an individual nurse practitioner in Florence, Mississippi, licensed in Mississippi (903096) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073086005
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameBRADLEY KEITH SHIELDS
Location Address128 EARL CLARK DRFlorence, MS 39073-6604
Mailing Address128 Earl Clark DrFlorence, MS 39073-6604 · (601) 891-8465 · Fax (601) 891-8468
Fax(601) 891-8468
Sole ProprietorNo
Enumeration DateJanuary 2, 2019
NPI 1073086005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in MS · 903096
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

128 EARL CLARK DR, Florence, MS 39073

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Bradley Keith Shields is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
128 EARL CLARK DR
FLORENCE, MS 39073
Family Medicine
128 EARL CLARK DR
FLORENCE, MS 39073

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Shields's NPI number?

The NPI number for Bradley Shields is 1073086005. It was assigned to this individual provider in the NPPES registry on January 2, 2019.

Where is Bradley Shields located?

Bradley Shields practices at 128 Earl Clark Dr, Florence, MS 39073. The listed phone number is (601) 891-8465.

What is Bradley Shields's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Bradley Shields enrolled in Medicare?

Yes. Bradley Shields is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bradley Shields was last updated on January 2, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.