SHIELDS SIGNATURE IMAGING LLC NPI 1417320912

NPI Information

  • NPI: 1417320912
  • Provider Name: SHIELDS SIGNATURE IMAGING, LLC
  • Classification: Clinic/Center - 261QR0208X
  • Specialization: Radiology, Mobile
  • Entity Type: Organization
  • CLIA Number: 22D2119841
  • Address: 680 CENTRE ST
    BROCKTON, MA
    ZIP 02302
  • Phone: (866) 258-4738

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NPI Details

SHIELDS SIGNATURE IMAGING, LLC is a radiology and mobile clinic center in Brockton, MA. SHIELDS SIGNATURE IMAGING, LLC NPI is 1417320912. The provider is registered as an organization entity type.

The provider's business location address is:

680 CENTRE ST
BROCKTON, MA
ZIP 02302-308
Phone: (866) 258-4738

The provider's authorized official is Kristen Delmore .
The authorized official title is Cfo and has the following contact phone number (617) 376-7400.

The CLIA number assigned to this NPI record is 22D2119841 - other - clinic with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Piflufolastat f-18, diagnostic, 1 millicurie (HCPCS:A9595)
  • Nuclear medicine study from skull base to mid-thigh with ct scan (HCPCS:78815)
  • Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries (HCPCS:A9552)
  • Nuclear medicine study whole body with ct scan (HCPCS:78816)

The enumeration date for this NPI number is 11/5/2015 and was last updated on 6/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0208XClinic/CenterRadiology, MobileYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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