NPIMap

Organization Active NPI

Jeffrey K Shaw DC PLLC

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1528178357
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
JEFFREY K SHAW DC PLLC
Practice address
10975 E Brewery Creek Lane
Traverse City, MI 49684
Phone
(231) 947-0755
Fax
(231) 947-1134
NPI assigned
Aug 30, 2006
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Dr. Jeffrey Kenneth Shaw, DCNPI 1033253059
Title
Owner
Phone
(231) 947-0755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

10975 E Brewery Creek Lane
Traverse City, MI 49684

Mailing address

10975 E Brewery Creek Lane
Traverse City, MI 49684
Phone (231) 947-0755

Other names 1

  • jeffrey k shaw dc pllc Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1528178357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10975 E BREWERY CREEK LANE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-947-0755",
            "fax_number": "231-947-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10975 E BREWERY CREEK LANE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-947-0755",
            "fax_number": "231-947-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY K SHAW DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-947-0755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "jeffrey k shaw dc pllc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.