NPIMap

Organization Active NPI

Shadow Mountain Chiropractic Clinic PC

  • Chiropractor
  • Granby, CO
National Provider Identifier
1336340314
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1596 Issued in CO
Legal business name
SHADOW MOUNTAIN CHIROPRACTIC CLINIC PC
Practice address
60 Second St
Granby, CO 80446-0036
Phone
(970) 887-3131
Fax
(970) 887-3913
NPI assigned
May 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey W Shaw, D. C.NPI 1003955964
Title
President
Phone
(970) 887-3131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1596 CO Primary

Addresses

Primary practice location

60 Second St
Granby, CO 80446-0036

Mailing address

PO Box 36
Granby, CO 80446-0036
Phone (970) 887-3131

National Provider Directory

National Provider Directory

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": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336340314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "city": "GRANBY",
            "state": "CO",
            "postal_code": "804460036",
            "telephone_number": "970-887-3131",
            "fax_number": "970-887-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SECOND ST",
            "city": "GRANBY",
            "state": "CO",
            "postal_code": "804460036",
            "telephone_number": "970-887-3131",
            "fax_number": "970-887-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-887-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granby, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.