Individual provider Active NPI

Aaron Brett Shaw

  • Nursing Care Agency
  • Flagstaff, AZ
National Provider Identifier
1063244986
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
5275148-3102 Issued in UT
Practice address
930 N Switzer Canyon Dr Ste 101
Flagstaff, AZ 86001-4834
Phone
(928) 499-3100
NPI assigned
Aug 19, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 315677 AZ
Nursing Care Agency 251J00000X 5275148-3102 UT Primary

Addresses

Primary practice location

930 N Switzer Canyon Dr Ste 101
Flagstaff, AZ 86001-4834

Mailing address

3835 E Viking Dr
Eden, UT 84310-6802
Phone (801) 663-6671

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

State licenses

LicenseStateTypeSpecialty
315677AZMDGeriatric Medicine (Family Medicine) Physician
5275148-3102UTMDNursing Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1063244986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 E VIKING DR",
            "city": "EDEN",
            "state": "UT",
            "postal_code": "843106802",
            "telephone_number": "801-663-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N SWITZER CANYON DR STE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014834",
            "telephone_number": "928-499-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AARON",
        "middle_name": "BRETT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "315677",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "UT",
            "license": "5275148-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.