Active NPI
Jacob Austin Shaw, PARAMEDIC
- Military Health Care Provider
- Indianapolis, IN
National Provider Identifier
1083505481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- M5148988
- Practice address
- 6704 Smithfield Blvd
Indianapolis, IN 46237-9106 - Phone
- (317) 619-6884
- Fax
- (317) 619-6884
- NPI assigned
- Jul 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | M5148988 | IN | Primary |
Addresses
Primary practice location
6704 Smithfield Blvd
Indianapolis, IN 46237-9106
Mailing address
6704 Smithfield Blvd
Indianapolis, IN 46237-9106
Phone (317) 619-6884
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
| License | State | Type | Specialty |
|---|---|---|---|
| M5148988 | IN | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1083505481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6704 SMITHFIELD BLVD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462379106",
"telephone_number": "317-619-6884",
"fax_number": "317-619-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6704 SMITHFIELD BLVD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462379106",
"telephone_number": "317-619-6884",
"fax_number": "317-619-6884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "JACOB",
"middle_name": "AUSTIN",
"credential": "PARAMEDIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-14",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "IN",
"license": "M5148988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.