Individual provider Active NPI

Rosamond Sterling Shaw, D.M.D.

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1457452302
Registry record updated Oct 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3545 Issued in AL
Practice address
4702 Misty Ridge Cir.
Birmingham, AL 35235
Phone
(205) 769-6238
Fax
(205) 769-6245
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3545 AL Primary

Addresses

Primary practice location

4702 Misty Ridge Cir.
Birmingham, AL 35235

Mailing address

4702 Misty Ridge Cir.
Birmingham, AL 35235
Phone (205) 769-6238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160916001562 AL Order and Referring Only - DentistPractitioner - Dentist 8527355635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1457452302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIR.",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-769-6238",
            "fax_number": "205-769-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIR.",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-769-6238",
            "fax_number": "205-769-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROSAMOND",
        "middle_name": "STERLING",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.