Organization Active NPI

David G Shaw DC, PA

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1205108933
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DAVID G SHAW DC, PA
Practice address
1626 S Conway Rd
Orlando, FL 32812-2705
Phone
(407) 851-0980
Fax
(407) 851-0918
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. David G Shaw, DCNPI 1336207620
Title
Owner/Physician
Phone
(407) 851-0980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1626 S Conway Rd
Orlando, FL 32812-2705

Mailing address

1626 S Conway Rd
Orlando, FL 32812-2705
Phone (407) 851-0980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050215000201 FL Part B Supplier - Clinic/Group Practice 9133171481 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory
Tax ID family
David G Shaw DC PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5626 Curry Ford Rd
Ste 250
Orlando, FL 32822
Phone (407) 377-0737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1205108933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122705",
            "telephone_number": "407-851-0980",
            "fax_number": "407-851-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 S CONWAY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122705",
            "telephone_number": "407-851-0980",
            "fax_number": "407-851-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID G SHAW DC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "407-851-0980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.