Robert C. Shaw Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01061706A Issued in IN

Practice address

1098 S State Road 25
Logansport, IN 46947-6723

Phone

(574) 722-4141

Fax

(574) 735-3414

NPI assigned

Jul 7, 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

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pine Rest Christian Mental Health Services

  • General Practice Physician
  • Grand Rapids, MI
  • NPI 1851309884
  Medicare reassignment NPD
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD
• Pine Rest Christian Mental Health Services

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1700894623
  NPD
• Southeastern Michigan Services, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • Detroit, MI
  • NPI 1558442830
  NPD (past)
• State of Michigan Office of Financial Management

  • Psychiatric Hospital
  • Caro, MI
  • NPI 1194767996
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366474710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 S STATE ROAD 25",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469476723",
            "telephone_number": "574-722-4141",
            "fax_number": "574-735-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 S STATE ROAD 25",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469476723",
            "telephone_number": "574-722-4141",
            "fax_number": "574-735-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROBERT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01061706A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mildred Seneriz
• Servant'S Heart Home Health Services, Inc.
• Servant'S Heart Homemaker Services, LLC
• Megan Elizabeth Shaal, PSY.D., HSPP
• Owen Craig Shanteau, DDS
• Daniel Alan Shemwell, MSED.
• Jessica Shepler, PHARMD
• Kathleen Snider Shepler, O.D.
• Sheridan Healthcare of Indiana PC
• Karen Lee Shidler, R.N., B.S.N., C.D.E.

• Psychiatry Physician in Logansport, IN
• Providers in Logansport, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.