Active NPI
Dominic Shiu, M.D.
- Family Medicine Physician
- Glenwood, IA
National Provider Identifier
1003962994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30374
- Practice address
- 711 S Vine St
Glenwood, IA 51534-1927 - Phone
- (712) 520-2210
- Fax
- (712) 525-1459
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30374 | IA | Primary |
Addresses
Primary practice location
711 S Vine St
Glenwood, IA 51534-1927
Mailing address
711 S Vine St
Glenwood, IA 51534-1927
Phone (712) 520-2210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003962994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 S VINE ST",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "515341927",
"telephone_number": "712-520-2210",
"fax_number": "712-525-1459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 S VINE ST",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "515341927",
"telephone_number": "712-520-2210",
"fax_number": "712-525-1459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIU",
"first_name": "DOMINIC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "30374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenwood, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.