Clayton Towner Shaw, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11751 Issued in CO

Practice address

64 S Star Rd
Star, ID 83669-5497

Phone

(208) 268-0089

Fax

(208) 488-4248

NPI assigned

Jul 27, 2012

Last updated

Oct 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehabauthority LLCGroup PAC ID 1355333931, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690

  ID, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Denver Physical Therapy, P.C.

  dba Pro Active Physical Therapy Strasburg

  • Physical Therapist
  • Strasburg, CO
  • NPI 1710141080
  NPD (past)
• Eastern Plains Therapy PC

  • Specialist
  • Strasburg, CO
  • NPI 1952329997
  NPD (past)

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1245586270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 W IOWA AVENUE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "208-467-7889",
            "fax_number": "208-467-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 S STAR RD",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836695497",
            "telephone_number": "208-268-0089",
            "fax_number": "208-488-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CLAYTON",
        "middle_name": "TOWNER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "11751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Joana Rojas-Bautista, R.D.N.
• Krysia Kristine Rousseau, DPT
• Kari-Lyn Ruby, LMT
• Melinda W Sater, PHARM.D.
• Kourtney Schaffner, CCC-SLP
• Alyssa Shirley, OTR/L
• Kaili Michelle Smalley
• Elizabeth Dockerty Smith, DDS, MSD
• Jennifer Lynn Snow, PTA
• Megan Socha, RDN

• Physical Therapist in Star, ID
• Providers in Star, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.