Active NPI
David Douglas Shaw, CPO
- Prosthetist
- Williston, VT
National Provider Identifier
1548307275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- Practice address
- 312 Commerce St
Unit 10
Williston, VT 05495-7832 - Phone
- (802) 864-9909
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | |||
| Prosthetist | 224P00000X | Primary |
Addresses
Primary practice location
312 Commerce St
Unit 10
Williston, VT 05495-7832
Mailing address
312 Commerce St
Unit 10
Williston, VT 05495-7832
Phone (802) 864-9909
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009187 | Medicaid | VT | |
| 01060791 | Medicaid | NY | |
| 054 2771 | Other | VT | BLUE CROSS BLUE SHIELD |
Other names 1
- D. Douglas Shaw
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D. Douglas Shaw | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Prosthetic/Orthotic Supplier
- Williston, VT
- NPI 1659544054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1548307275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 COMMERCE ST",
"address_2": "UNIT 10",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957832",
"telephone_number": "802-864-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 COMMERCE ST",
"address_2": "UNIT 10",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957832",
"telephone_number": "802-864-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "DAVID",
"middle_name": "DOUGLAS",
"credential": "CPO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009187",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01060791",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "054 2771",
"state": "VT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "D.",
"last_name": "SHAW",
"middle_name": "DOUGLAS",
"credential": "CPO",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.