Keiba Lynn Shaw, PT, EDD

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT20924 Issued in FL

Practice address

3632 Queen Palm Drive
Tampa, FL 33619-1154

Phone

(813) 574-5318

NPI assigned

Apr 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: keiba.shaw.1@18455.direct.athenahealth.com

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1477879997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 QUEEN PALM DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336192047",
            "telephone_number": "813-574-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 QUEEN PALM DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191154",
            "telephone_number": "813-574-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KEIBA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PT, EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT20924",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "10726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie Jo M Shaw, MS
• Colleen O'Hara Shaw, AOCNP, ARNP
• David E. Shaw Jr., LCSW
• Devin C Shaw, CRNA
• Kailie Shaw, MD
• Kimberly Frances Shaw, LMSW
• Lauren Shaw, PA-C
• Lauren Bass Shaw, APRN
• Mattie Lynn Shaw, MS
• Maurice H Shaw, MD

• Geriatric Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Geriatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; 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.