Individual provider Active NPI

Julie K Anderson-Shaw, D.C.

  • Chiropractor
  • Brazil, IN
National Provider Identifier
1497703052
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001618 Issued in IN
Practice address
78 Forest Park PLZ
Brazil, IN 47834-2737
Phone
(812) 443-2225
Fax
(812) 443-2226
NPI assigned
May 5, 2006
Last updated
Mar 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001618 IN Primary

Addresses

Primary practice location

78 Forest Park PLZ
Brazil, IN 47834-2737

Mailing address

78 Forest Park PLZ
P.O. Box 481
Brazil, IN 47834-2737
Phone (812) 443-2225

Other identifiers 1

IdentifierTypeStateIssuer
200072290MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111102000527 IN Practitioner - Chiropractic 4587837802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Anderson-Shaw Chiropractic IncGroup PAC ID 1951574276, 2 clinicians

Practice addresses (Care Compare)

78 Forest Park PLZ
Brazil, IN 47834-2737
Phone (812) 443-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001618INMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson-Shaw Chiropractic Inc Chiropractor CurrentSince Jun 1, 1999 Accepting new patients

Locations

78 Forest Park Plz
Brazil, IN 47834
Phone (812) 443-2225

4320 S 7th St
Terre Haute, IN 47802
Phone (812) 299-7000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1497703052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 FOREST PARK PLZ",
            "address_2": "P.O. BOX 481",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478342737",
            "telephone_number": "812-443-2225",
            "fax_number": "812-443-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 FOREST PARK PLZ",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "478342737",
            "telephone_number": "812-443-2225",
            "fax_number": "812-443-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-SHAW",
        "first_name": "JULIE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brazil, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.