Keith Alan Shaw, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

22393 Issued in IA

Practice address

1515 Delhi St
Ste 200
Dubuque, IA 52001-6314

Phone

(563) 557-7000

Fax

(563) 589-4050

NPI assigned

Jan 18, 2006

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1346220282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DELHI ST",
            "address_2": "STE 200",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016314",
            "telephone_number": "563-557-7000",
            "fax_number": "563-589-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DELHI ST",
            "address_2": "STE 200",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016314",
            "telephone_number": "563-557-7000",
            "fax_number": "563-589-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Galena",
            "state": "IL",
            "postal_code": "610368118",
            "country_code": "US",
            "telephone_number": "815-777-1340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KEITH",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "22393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30508300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184580",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "midwestmedical@midwestmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Midwest Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Medical Center Dr",
            "city": "Galena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610368118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Chandler Severson
• Tina Lee Shade, MT
• Michelle Shafer, D.O.
• Roger D. Shafer, M.D.
• Benjamin Allen Shaw, L.I.S.W.
• Shelby Anna Shelley
• Amy Sherman
• Jessica Sherman, OTR/L
• Karoline Sheston
• Todd Shields, RPH

• Surgery Physician in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.