Heather Denise Shaw

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

536019 Issued in WI

Practice address

601 N Briarcliff Dr
Appleton, WI 54915-2959

Phone

(920) 739-4466

NPI assigned

Oct 12, 2009

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1487989349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N BRIARCLIFF DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549152959",
            "telephone_number": "920-739-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BRIARCLIFF DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549152959",
            "telephone_number": "920-739-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "HEATHER",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "536019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56019",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauryn B Sexton, CD
• Hassan Shahbandar, MD
• Danielle L Shannon, RDH
• Marc Shantz
• Brittany K Shaw, CD
• Carolyn Shea
• Derrick Randall Shearer, PHARMD
• Zaheeruddin Sheikh, MD
• Curtis P Sheldon, CRNA, MS APNA
• Kathleen J Sheridan, APNP

• Physical Therapy Assistant in Appleton, WI
• Providers in Appleton, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.