Trent E Shaw, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-308 Issued in ID

Practice address

72 E Main St
Rexburg, ID 83440-1926

Phone

(208) 359-1770

Fax

(208) 359-1780

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment Care Compare group NPD
• Intermountain Emergency Physicians

  • Emergency Medicine Physician
  • Idaho Falls, ID
  • NPI 1124005467
  Medicare reassignment
• Community Care, PLLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1003088782

  Physician Assistant

  NPD (past)
• Mountain View Hospital Physician Organization

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1073834529
  NPD (past)

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

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1366488926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401926",
            "telephone_number": "208-359-1770",
            "fax_number": "208-359-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401926",
            "telephone_number": "208-359-1770",
            "fax_number": "208-359-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TRENT",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-308",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806887500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Widdison Scott, M.COUN.
• Seasons Medical, PLLC
• Hailee Lynn Sebra
• Gary R Sena, PA-C
• Serene Horizons Health, PC
• Julie B. Shiffler, PH.D.
• Justin Shippen, DO
• Emily Shore, LCSW
• Adam Louis Shurtz, DPT
• Alicia G Siddoway, RPT

• Medical Physician Assistant in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.