Individual provider Active NPI

James Stephen Shaw, MD

  • Pediatrics Physician
  • Bethesda, MD
National Provider Identifier
1053555649
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0036013 Issued in MD
Practice address
Nih BLDG 10 Rm4B36 MSC 1360
10 Center Drive
Bethesda, MD 20892-0001
Phone
(301) 435-6499
NPI assigned
Apr 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0036013 MD Primary

Addresses

Primary practice location

Nih BLDG 10 Rm4B36 MSC 1360
10 Center Drive
Bethesda, MD 20892-0001

Mailing address

5708 Glenwood Rd
Bethesda, MD 20817-6730
Phone (301) 656-4889

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0036013MDMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1053555649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 GLENWOOD RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208176730",
            "telephone_number": "301-656-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NIH BLDG 10 RM4B36 MSC 1360",
            "address_2": "10 CENTER DRIVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-435-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JAMES",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0036013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.