Individual provider Active NPI

Jonathan Stephen Shaw, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Norton Shores, MI
National Provider Identifier
1356672794
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
EMC0002741 Issued in MI
Practice address
6401 Prairie St Ste 1700
Norton Shores, MI 49444-7843
Phone
(231) 672-7944
Fax
(231) 672-7994
NPI assigned
Jan 25, 2010
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 18596 NH
Obstetrics & Gynecology Physician 207V00000X EMC0002741 MI
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X EMC0002741 MI Primary

Addresses

Primary practice location

6401 Prairie St Ste 1700
Norton Shores, MI 49444-7843

Mailing address

PO Box 776982
Chicago, IL 60677-6982
Phone (800) 494-5797

Other identifiers 1

IdentifierTypeStateIssuer
13566727944MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230830001808 MI Practitioner - Obstetrics/Gynecology 7214291079 Reassigns benefits to 2 organizations
I20241003000405 TN Practitioner - Obstetrics/Gynecology 7214291079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

979 E 3Rd St
Suite C735
Chattanooga, TN 37403-3310
Phone (423) 778-9101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Aug 21, 2023 Accepting new patients
Cheshire Medical Center Current Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Aug 21, 2023 Accepting new patients
Erlanger Health Obstetrics & Gynecology CurrentSince Sep 9, 2024 Accepting new patients
Erlanger Health CurrentSince Sep 9, 2024 Accepting new patients
Mercy Health Partners - Physician Specialist CurrentSince Aug 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority Obstetrics & Gynecology Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

2144 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-2100

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1755 Gunbarrel Rd
Ste 301
Chattanooga, TN 37421
Phone (423) 756-2773

979 E 3rd St
Ste C725
Chattanooga, TN 37403
Phone (423) 756-4796

979 E 3rd St
Ste C735
Chattanooga, TN 37403
Phone (423) 778-9101

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Interoperability endpoints

  • Direct secure messaging: jshaw2803492@direct.trinity-health.org
  • Direct secure messaging: jshaw314202@direct.dartmouth-hitchcock.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1356672794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776982",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776982",
            "telephone_number": "800-494-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PRAIRIE ST STE 1700",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447843",
            "telephone_number": "231-672-7944",
            "fax_number": "231-672-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JONATHAN",
        "middle_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NH",
            "license": "18596",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "EMC0002741",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MI",
            "license": "EMC0002741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13566727944",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.