Individual provider Active NPI

Shawn David Isaacs, D.C.

  • Chiropractor
  • Evansville, IN
National Provider Identifier
1063838753
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002757A Issued in IN
Practice address
958 S Kenmore Dr
Evansville, IN 47714-7513
Phone
(812) 477-5003
Fax
(812) 477-3639
NPI assigned
Mar 5, 2014
Last updated
Mar 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002757A IN Primary

Addresses

Primary practice location

958 S Kenmore Dr
Evansville, IN 47714-7513

Mailing address

958 S Kenmore Dr
Evansville, IN 47714-7513
Phone (812) 477-5003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140425001013 IN Practitioner - Chiropractic 6406089531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Evansville Rehabilitation PCGroup PAC ID 0143219030, 3 clinicians

Practice addresses (Care Compare)

120 N Fulton Ave
Evansville, IN 47710-1002
Phone (812) 303-0369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002757AINMDChiropractor

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1063838753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-477-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 S KENMORE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477147513",
            "telephone_number": "812-477-5003",
            "fax_number": "812-477-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "SHAWN",
        "middle_name": "DAVID",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002757A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.