Collie Blevins Shaw, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C7970 Issued in AR

Practice address

2200 Ada Ave
Suite 202
Conway, AR 72034-4985

Phone

(501) 327-3929

Fax

(501) 329-3816

NPI assigned

Jul 12, 2005

Last updated

Jul 10, 2007By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

OtolaryngologyAlso: Allergy/Immunology

Education

University of Arkansas College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Arkansas Ear Nose and Throat ClinicGroup PAC ID 1951466614, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Arkansas Ear Nose & Throat Clinic

  • Otolaryngology Physician
  • Conway, AR
  • NPI 1093772436
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Conway Regional Medical Center Inc

  dba Conway Regional Medical Clinic-Vilonia

  • Rural Health Clinic/Center
  • Vilonia, AR
  • NPI 1063798858

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1497770424
  Care Compare affiliation
• Conway Regional Medical Center Inc

  • Clinical Medical Laboratory
  • Conway, AR
  • NPI 1609123017

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  dba Conway Regional Medical Clinic-Russellville

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1245729359

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  dba Conway Regional Counseling Center

  • Psychiatry Physician
  • Conway, AR
  • NPI 1730402249

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc.

  dba Mayflower Medical Clinic

  • Rural Health Clinic/Center
  • Mayflower, AR
  • NPI 1851389605

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1598763641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE",
            "address_2": "SUITE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-327-3929",
            "fax_number": "501-329-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE",
            "address_2": "SUITE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-327-3929",
            "fax_number": "501-329-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COLLIE",
        "middle_name": "BLEVINS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "C7970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127214001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexys Shankle
• Savannah Shankles
• Taylor Anne Shapley
• Kristen Faith Sharp
• Mary J Shaver, M.D.
• Valeid Sheikh, DO
• Brandon Shelley
• Rachel J Shepherd
• Carrie Beth Sherwood, MHPP
• Huiping Shi

• Otolaryngology Physician in Conway, AR
• Providers in Conway, AR by specialty
• Otolaryngology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.