Individual provider Active NPI

Joel David Shaw

  • Certified Registered Nurse Anesthetist
  • Iowa City, IA
National Provider Identifier
1467617456
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D109105 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1007
Phone
(319) 356-2633
Fax
(319) 356-2940
NPI assigned
Jul 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 109105 IA
Certified Registered Nurse Anesthetist 367500000X D109105 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1007

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1007
Phone (319) 356-2633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813000995 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375677297 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grinnell Regional Medical CenterGroup PAC ID 0446153662, 98 clinicians

Practice addresses (Care Compare)

210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-7511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
D109105IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Anesthesia Iowa PLC CurrentSince Jul 1, 2013 Accepting new patients
Mahaska County Hospital Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
Mahaska County Hospital Current Accepting new patients
Grinnell Regional Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jun 18, 2023 Accepting new patients
Anesthesia Associates of Kansas City PA Past Accepting new patients

Locations

210 4th Ave
Grinnell, IA 50112
Phone (641) 236-2055

1229 C Ave E
Oskaloosa, IA 52577
Phone (641) 672-3100

201 Trueblood Ave
Oskaloosa, IA 52577
Phone (641) 672-3360

404 Jefferson St
Pella, IA 50219
Phone (641) 628-3150

Interoperability endpoints

  • Direct secure messaging: jshaw957544@direct.unitypoint.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1467617456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421007",
            "telephone_number": "319-356-2633",
            "fax_number": "319-356-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421007",
            "telephone_number": "319-356-2633",
            "fax_number": "319-356-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-19",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "109105",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D109105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.