J Elaine Shaw, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G3781 Issued in TX

Practice address

1505 State Highway 19 S
Athens, TX 75751-8950

Phone

(903) 675-1725

Fax

(903) 675-7668

NPI assigned

Feb 21, 2006

Last updated

May 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1508831942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757125500",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 STATE HIGHWAY 19 S",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757518950",
            "telephone_number": "903-675-1725",
            "fax_number": "903-675-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "J",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G3781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THSTEPS-MEDICAID",
            "identifier": "121323304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121323301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennie Lee Schneider, FNP-C
• Troy Scott, ATC, LAT
• Stephanie Self
• Dylan Humberto Serrano
• Syed Asif Shah, MD
• Madison Leigh Sheets, PHARMD
• Melissa L Sheldon, FNP-C
• Halsey Taylor Shults, PHARMD, RPH
• Amy Jo Shuptrine, MSN, APRN, FNP-BC
• Tifani Poskey Shuttlesworth, D.D.S.

• Pediatrics Physician in Athens, TX
• Providers in Athens, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.