NPIMap

Organization Active NPI

Shaw Chiropractic and Sports Injury Center

Doing business as Shaw Chiropractic & Sports Injury Center

  • Chiropractor
  • Clive, IA
National Provider Identifier
1003240821
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007096 Issued in IA
Legal business name
SHAW CHIROPRACTIC AND SPORTS INJURY CENTER
Doing business as
Shaw Chiropractic & Sports Injury Center
Practice address
2555 Berkshire Pkwy
Suite F
Clive, IA 50325-4646
Phone
(515) 987-6332
NPI assigned
Aug 28, 2013
Last updated
Sep 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Abel Jonathan Shaw, D.C.NPI 1700061991
Title
Owner
Phone
(515) 987-6332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007096 IA Primary

Addresses

Primary practice location

2555 Berkshire Pkwy
Suite F
Clive, IA 50325-4646

Mailing address

2555 Berkshire Pkwy
Suite F
Clive, IA 50325-4646
Phone (515) 987-6332

Other names 1

  • Shaw Chiropractic & Sports Injury Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131003000578 IA Part B Supplier - Clinic/Group Practice 6103050240 Receives reassigned benefits from 2 practitioners
Practice locations: Clive, IA

National Provider Directory

National Provider Directory

Locations

2555 Berkshire Pkwy
Ste F
Clive, IA 50325
Phone (515) 987-6332

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1003240821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 BERKSHIRE PKWY",
            "address_2": "SUITE F",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254646",
            "telephone_number": "515-987-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 BERKSHIRE PKWY",
            "address_2": "SUITE F",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254646",
            "telephone_number": "515-987-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW CHIROPRACTIC AND SPORTS INJURY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ABEL",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-987-6332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shaw Chiropractic & Sports Injury Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.