G. Lyman Shaw, D.C., F.A.C.O.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

08001024 Issued in IN

Practice address

17 Motif Blvd
Brownsburg, IN 46112-1017

Phone

(317) 852-3870

Fax

(317) 852-7417

NPI assigned

Oct 13, 2006

Last updated

Dec 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Gary Lyman Shaw II Other name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1114017084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 REDWOOD CT",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121947",
            "telephone_number": "317-852-5850",
            "fax_number": "317-852-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MOTIF BLVD",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121017",
            "telephone_number": "317-852-3870",
            "fax_number": "317-852-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "G.",
        "middle_name": "LYMAN",
        "name_prefix": "Dr.",
        "credential": "D.C., F.A.C.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IN",
            "license": "08001024",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IN",
            "license": "08001024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100133640",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "SHAW",
            "middle_name": "LYMAN",
            "prefix": "DR.",
            "suffix": "II",
            "credential": "D.C., F.A.C.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nathan Shafer, OD
• Shalom Care LLC
• Jessica Sharpe, RBT
• Paige Shattuck
• Aahkeem Shaw, RBT
• Kristian Shaw, RBT
• Andrea Chadwick Shelton, D.M.D.
• Lexia Noelle Shelton
• Tiarra Shepherd
• Holly Duvall Sherry

• Sports Physician Chiropractor in Brownsburg, IN
• Providers in Brownsburg, IN by specialty
• Sports Physician Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.