Individual provider Active NPI

Clifford R Shaw, MD

  • Occupational Medicine Physician
  • San Antonio, TX
National Provider Identifier
1023131802
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
PA01212 Issued in TX
Practice address
3453 North Hwy 35
Suite 110
San Antonio, TX 78219
Phone
(615) 778-4066
Fax
(615) 778-9114
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X PA01212 TX Primary

Addresses

Primary practice location

3453 North Hwy 35
Suite 110
San Antonio, TX 78219

Mailing address

720 Cool Springs Blvd
Suite 300
Franklin, TN 37067-2626
Phone (615) 778-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000202 TX Practitioner - Physician Assistant 6709058415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

3453 N Ih
35 Suite 120
San Antonio, TX 78219-2337
Phone (210) 293-3111

3453 N Pan Am Expy
Suite 110
San Antonio, TX 78219-2337
Phone (210) 226-7767

4025 S Padre Island Dr
Corpus Christi, TX 78411-4420
Phone (361) 852-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01212TXMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Jul 1, 2011 Accepting new patients
American Current Care, P.a. CurrentSince Jul 1, 2011 Accepting new patients

Locations

15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023131802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COOL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672626",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3453 NORTH HWY 35",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78219",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CLIFFORD",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "PA01212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.