Individual provider Active NPI

Joel Lewis Shaw, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Columbus, OH
National Provider Identifier
1457330078
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
35090113 Issued in OH
Practice address
3705 Olentangy River Rd
Ste 260
Columbus, OH 43214-3467
Phone
(614) 586-1220
Fax
(614) 586-1237
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 35090113 OH Primary

Addresses

Primary practice location

3705 Olentangy River Rd
Ste 260
Columbus, OH 43214-3467

Mailing address

5350 Frantz Rd
Dublin, OH 43016-4259

Other identifiers 1

IdentifierTypeStateIssuer
2823029MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshaw15269@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20071008000592 OH Practitioner - Orthopedic SurgeryPractitioner - Family PracticePractitioner - Sports Medicine 0941395750 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35090113OHMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Oct 1, 2007 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2007 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Max Sports Medicine Institute, Inc Past Accepting new patients

Locations

6200 Cleveland Ave
Columbus, OH 43231
Phone (614) 566-0590

3705 Olentangy River Rd
Fl 2
Columbus, OH 43214
Phone (614) 277-0141

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

290 E Town St
Columbus, OH 43215
Phone (614) 788-5400

3705 Olentangy River Rd
Ste 260
Columbus, OH 43214
Phone (614) 407-8552

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

5350 Frantz Rd
Dublin, OH 43016

4995 Bradenton Ave
Ste 130
Dublin, OH 43017
Phone (614) 580-6917

5610 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 476-1112

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

1797 Hill Rd N
Pickerington, OH 43147
Phone (614) 755-6370

4850 E Main St
Whitehall, OH 43213
Phone (614) 523-2266

Organizations & group practices 4

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1457330078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 FRANTZ RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 OLENTANGY RIVER RD",
            "address_2": "STE 260",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143467",
            "telephone_number": "614-586-1220",
            "fax_number": "614-586-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JOEL",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35090113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2823029",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshaw15269@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "290 E Town St",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.