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

Individual provider Medical Physician Assistant · NPI 1073999629

Nicole Marie Shields, PA-C is a Physician Assistant in Mount Clemens, Michigan. Qualified in 2015, 11 years ago. Practices with Independent Observation Physicians PLLC, a 136-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Licensed in
MI
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

133 S Main St
Mount Clemens, MI 48043-2308
Phone: (586) 468-1600
Fax: (586) 465-0329
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6071 W Outer Dr, Detroit, MI 48235-2624 — (313) 966-3300

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601007332 (MI)

Record details

NPI number1073999629
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 5, 2015
Last updated in NPPESMarch 7, 2023
Certification dateDecember 22, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Independent Observation Physicians Pllc — 136 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Mount Clemens