Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin L Shields, PA

Individual provider Physician Assistant · NPI 1730471368

Justin L Shields, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2011, 15 years ago. Practices with Mercy Specialty Services, a 84-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
15
Licensed in
MI
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

25 Michigan St NE Ste 5100
Grand Rapids, MI 49503-2572
Phone: (616) 267-0800
Fax: (616) 267-0801
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601006017 (MI)
Federally Qualified Health Center (FQHC) Taxonomy 261QF0400X

Record details

NPI number1730471368
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 16, 2011
Last updated in NPPESOctober 9, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Mercy Specialty Services — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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