Russell B Shields MD PC
Russell B Shields MD PC is a healthcare organization registered as Family Medicine Physician in Bountiful, UT, holding Type 2 (organization) NPI 1477543213 since 2005. The authorized official on file is Russell Shields, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1477543213 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Russell B Shields MD PC |
| Practice address | 425 MEDICAL DR, STE 108, Bountiful, UT, 84010 |
| Phone | 8012928444 |
| Fax | 8012928476 |
| Enumeration date | 2005-10-24 |
| Last updated in NPPES | 2008-04-08 |
Authorized official
| Name | Russell Shields |
|---|---|
| Title | President |
| Phone | 8012928444 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 528566304004 | Medicaid | UT | — |
Copy-ready billing details
Provider: Russell B Shields MD PC NPI: 1477543213 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 425 MEDICAL DR, STE 108, Bountiful, UT, 84010
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1235127291 | Kevin Clark | Individual | Surgery Physician | Bountiful, UT |
| 1942259197 | Sports Medicine Specialists, LLC | Organization | Sports Medicine (Family Medicine) Physician | Bountiful, UT |
| 1508811092 | Allan Edson | Individual | Family Medicine Physician | Bountiful, UT |
| 1972605012 | Michael Maudsley | Individual | Physical Therapist | Bountiful, UT |
| 1548363617 | Harold Pergler | Individual | Audiologist-Hearing Aid Fitter | Bountiful, UT |
| 1679643753 | Mvp Pharmacy LLC | Organization | Community/Retail Pharmacy | Bountiful, UT |
| 1235299561 | Rodney M. Jex Dpm | Organization | Foot & Ankle Surgery Podiatrist | Bountiful, UT |
| 1790844165 | Perry Walters | Individual | Urology Physician | Bountiful, UT |
Verify this record
Cross-check NPI 1477543213 against the authoritative CMS record: view Russell B Shields MD PC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Russell B Shields MD PC?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-04-08.