Individual provider Active NPI

Melissa Sue Shaw, D.C.

  • Chiropractor
  • Holmdel, NJ
National Provider Identifier
1366622359
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00661700 Issued in NJ
Practice address
761 Palmer Ave Ste 6
Holmdel, NJ 07733-1067
Phone
(732) 787-5597
Fax
(732) 787-5597
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00661700 NJ Primary

Addresses

Primary practice location

761 Palmer Ave Ste 6
Holmdel, NJ 07733-1067

Mailing address

761 Palmer Ave Ste 6
Holmdel, NJ 07733-1067
Phone (732) 787-5597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shaw Chiropractic, LLC Chiropractor PastSince Apr 11, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1366622359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 PALMER AVE STE 6",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331067",
            "telephone_number": "732-787-5597",
            "fax_number": "732-787-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 PALMER AVE STE 6",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331067",
            "telephone_number": "732-787-5597",
            "fax_number": "732-787-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00661700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.