David Brian Shaw, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810004175 Issued in VA

Practice address

611 Ironwood Dr
Yorktown, VA 23693-5560

Phone

(757) 788-9141

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1376542241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007C VICTORY BLVD # 387",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935601",
            "telephone_number": "757-788-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 IRONWOOD DR",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236935560",
            "telephone_number": "757-788-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810004175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGIST LICENSE",
            "identifier": "0810004175",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dianne Renee Segura, PTA
• Sarah Lynne Semones, RN, MS, PMHCNS, NP-C
• Sentara Medical Group
• Tatiyana Marie Settles
• Omar Shahid, BDS, MDS, FRCDC
• Tipton Kesner Sheets, LPC, LMFT, PLC
• Yuriko Sheppard, LMT
• Perry L Showalter, D.D.S.
• Rachel Marie Silva
• Supreet Singh

• Psychologist in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.