Joe Dean Shaw II

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

820 15TH St
Sparks, NV 89431-0939

Phone

(775) 378-1916

NPI assigned

Oct 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1336781905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10060 RACCOON CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239605",
            "telephone_number": "775-378-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 15TH ST",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894310939",
            "telephone_number": "775-378-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JOE",
        "middle_name": "DEAN",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "joeshawat@gmail.com",
            "affiliation": "N",
            "address_1": "820 15th St",
            "city": "Sparks",
            "state": "NV",
            "country_code": "US",
            "postal_code": "894310939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Sparks, NV
• Providers in Sparks, NV by specialty
• Student in an Organized Health Care Education/Training Program in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; 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.