Active NPI
Douglas B Shaw, MD
- Anesthesiology Physician
- Birmingham, AL
National Provider Identifier
1235157587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 10698
- Practice address
- 619 19TH Street South
Birmingham, AL 35233 - Phone
- (205) 934-6600
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 10698 | AL | Primary |
Addresses
Primary practice location
619 19TH Street South
Birmingham, AL 35233
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051511217 | Other | AL | BLUE CROSS |
| 051537904 | Other | AL | BLUE CROSS |
| D08149 | Other | AL | VIVA |
| 000011194 | Other | AL | BLUE CROSS |
| 902107800 | Other | FL | FLORIDA MEDICAID |
| 000011194 | Medicaid | AL | |
| 00112131 | Medicaid | MS | |
| 50053254 | Other | AL | RAILROAD MEDICARE |
| 0009940033 | Medicaid | AL | |
| 010033CD08149 | Other | AL | SECTION 1011 |
| 051511216 | Other | AL | BLUE CROSS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10698 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308096000000",
"number": "1235157587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310",
"telephone_number": "205-731-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH STREET SOUTH",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35233",
"telephone_number": "205-934-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "DOUGLAS",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2011-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AL",
"license": "10698",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051511217",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051537904",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "D08149",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000011194",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA MEDICAID",
"identifier": "902107800",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000011194",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00112131",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "50053254",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009940033",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECTION 1011",
"identifier": "010033CD08149",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051511216",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.