Chalyse H. Shaw, DC, PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

S01715PT Issued in MD

Legal business name

CHALYSE H. SHAW, DC, PC

Practice address

17112 York Rd
Parkton, MD 21120-9717

Phone

(410) 357-4889

Fax

(410) 357-4435

NPI assigned

May 12, 2010

Last updated

May 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chalyse H Shaw, DCNPI 1891843058

Title

President

Phone

(410) 357-4889

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

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.

• Chalyse H. Shaw, DC

  • Nutrition Chiropractor
  • Parkton, MD
  • NPI 1891843058
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1245558493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560",
            "city": "HEREFORD",
            "state": "MD",
            "postal_code": "211110560",
            "telephone_number": "410-357-4889",
            "fax_number": "410-357-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17112 YORK RD",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209717",
            "telephone_number": "410-357-4889",
            "fax_number": "410-357-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHALYSE H. SHAW, DC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CHALYSE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-357-4889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "S01715PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "M253CH",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUECHOICE",
            "identifier": "R7290001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Bernard, PHARMD
• Nicolle Beatrice Birckhead, LCSW-C
• Teresa Ann Boshears, MSW
• Stanley Caplan
• Sandra Lynn Carl, PHARM D
• Heidi Chesla, MPT
• Randolph S Chiat, BS
• Linda Coratti, PT
• Beverly June Davis Bye, CRNP
• Erin Debonis

• Medical Specialty Clinic/Center in Parkton, MD
• Providers in Parkton, MD by specialty
• Medical Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.