{
"Npi": {
"NPI": "1134178312",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHIELDS HEALTHCARE OF CAMBRIDGE, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "700 CONGRESS ST STE 204",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "QUINCY",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02169-0928",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "385 WESTERN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRIGHTON",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02135-1005",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-621-2955",
"PracticeLocationAddressFaxNumber": "508-897-3599",
"EnumerationDate": "05/08/2006",
"LastUpdateDate": "06/09/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DELMORE",
"AuthorizedOfficialFirstName": "KRISTEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "617-376-7400",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "4420",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM1200X",
"TaxonomyName": "Magnetic Resonance Imaging (MRI) Clinic/Center",
"LicenseNumber": "4420",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}