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SHIELDS SIGNATURE IMAGING, LLC
NPI 1417320912
Clinic/Center - Radiology, Mobile in Brockton, MA

Active since November 05, 2015CLIA 22D2119841 · Waiver
680 CENTRE ST, BROCKTON, MA 02302(866) 258-4738 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 17, 2026, Mar 19, 2026, Jun 9, 2025 and 1 more (4 updates tracked since 2021).

About Shields Signature Imaging, Llc NPPES

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

SHIELDS SIGNATURE IMAGING, LLC (NPI 1417320912) is a healthcare organization registered as a radiology, mobile in Brockton, Massachusetts and active in the NPI registry since November 2015. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Kristen Delmore, Cfo, as its authorized official.

NPPES Registry Identity

NPI1417320912
Entity TypeOrganization
Primary Taxonomy261QR0208X
Legal Business NameSHIELDS SIGNATURE IMAGING, LLC
Location Address680 CENTRE STBrockton, MA 02302-3308
Mailing Address700 Congress St Ste 204Quincy, MA 02169-0928 · (508) 897-1501 · Fax (508) 897-1599
Phone(866) 258-4738
Organization SubpartNo
Authorized OfficialKristen DelmoreCfo · (617) 376-7400
Enumeration DateNovember 5, 2015
Last NPPES UpdateApril 17, 20264 updates tracked since enumeration
NPPES CertifiedApril 17, 2026
✔ NPI 1417320912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Radiology, MobileAmbulatory Health Care Facilities
Taxonomy Code261QR0208X
680 CENTRE ST, Brockton, MA 02302
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2119841

Shields Signature Imaging · Brockton, MA
Active · expires Oct 4, 2026
CLIA Number22D2119841
Laboratory TypeClinic
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorStephen T. Sweriduk
Laboratory Phone(866) 258-4738
Laboratory LocationShields Signature Imaging680 Center Street, Brockton, MA 02302
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Piflufolastat f-18, diagnostic, 1 millicurie A9595
Piflufolastat F-18 is a radioactive diagnostic agent used in PET scans. It helps visualize certain cells in your body, aiding doctors in diagnosing specific conditions. This service involves injecting 1 millicurie of the agent into your body.
594 services63 patients
Nuclear medicine study from skull base to mid-thigh with ct scan 78815
A nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.
283 services224 patients
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries A9552
Fluorodeoxyglucose F-18 FDG is a radioactive drug used in PET scans. It helps doctors see how your tissues and organs are functioning. The drug is given in a specific dose, up to 45 millicuries, depending on your body size and the type of scan.
238 services175 patients
Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie A9596
Gallium Ga-68 Gozetotide (Illuccix) is a diagnostic procedure using a radioactive tracer. It helps visualize certain types of tumors in your body by injecting a small amount of radioactive material. This is safe and aids doctors in accurate diagnosis and treatment planning.
60 services12 patients
Nuclear medicine study whole body with ct scan 78816
A Nuclear Medicine Study with a CT Scan is a diagnostic procedure. It uses a small amount of radioactive substance and a CT scan to create detailed images of your body. These images help doctors diagnose, monitor, and treat various conditions.
39 services29 patients

Other Providers at the Same Location NPPES 20

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

LOUIS D. GOTTLIEB M.D.
Internal Medicine
680 CENTRE ST, MANAGED CARE
BROCKTON, MA 02302
Plymouth County (508) 941-7065
MS. JAMIE CHYAT PA-C
Physician Assistant
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 941-7000
BRANDEN M TURNER LMHC
Counselor (Mental Health)
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 941-7228
CARLY ALEXANDRA CARLIN MD
Psychiatry & Neurology (Psychiatry)
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 941-7228
DR. ANGEL TAYLOR MD
Student in an Organized Health Care Education/Training Program
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 974-7000
DR. DESIREE A CARLSON MD
Pathology (Anatomic Pathology & Clinical Pathology)
680 CENTRE ST, PATHOLOGY DEPARTMENT
BROCKTON, MA 02302
Plymouth County (508) 941-7414
DEMIN MA M.D.
Psychiatry & Neurology (Psychiatry)
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 941-7228
JENNIFER L. BUNKER
Social Worker
680 CENTRE ST
BROCKTON, MA 02302
Plymouth County (508) 941-7268

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 Shields Signature Imaging, LLC's NPI number?

The NPI number for Shields Signature Imaging, LLC is 1417320912. It was assigned to this organization in the NPPES registry on November 5, 2015.

Where is Shields Signature Imaging, LLC located?

Shields Signature Imaging, LLC is located at 680 Centre St, Brockton, MA 02302. The listed phone number is (866) 258-4738.

What is Shields Signature Imaging, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, Mobile, with taxonomy code 261QR0208X.

Does Shields Signature Imaging, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2119841) is associated with this NPI, valid through October 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Shields Signature Imaging, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Shields Signature Imaging, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shields Signature Imaging, LLC was last updated on April 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.