NPIMap

Organization Active NPI

Dr. Michael P. Shaw, a Professional Corporation, Inc.

  • Specialist
  • Modesto, CA
National Provider Identifier
1265672117
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35996 Issued in CA
Legal business name
DR. MICHAEL P. SHAW, A PROFESSIONAL CORPORATION, INC.
Practice address
2020 Standiford Ave Ste B
Modesto, CA 95350-6530
Phone
(209) 522-9339
Fax
(209) 525-9366
NPI assigned
Mar 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Elizabeth S. Shaw
Title
Practice Administrator
Phone
(209) 667-9339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35996 CA Primary

Addresses

Primary practice location

2020 Standiford Ave Ste B
Modesto, CA 95350-6530

Mailing address

222 Memory LN
Turlock, CA 95382-7272
Phone (209) 667-9339

National Provider Directory

National Provider Directory

Locations

2020 Standiford Ave
Ste B
Modesto, CA 95350
Phone (209) 522-9339

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1265672117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MEMORY LN",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953827272",
            "telephone_number": "209-667-9339",
            "fax_number": "209-664-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 STANDIFORD AVE STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506530",
            "telephone_number": "209-522-9339",
            "fax_number": "209-525-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHAEL P. SHAW, A PROFESSIONAL CORPORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "209-667-9339"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "35996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.