Individual provider Active NPI

Roseanne D Shaw, MD

  • Emergency Medicine Physician
  • Frisco, CO
National Provider Identifier
1639143753
Registry record updated Sep 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21960 Issued in CO
Practice address
Highway 9 and School Road
Frisco, CO 80443
Phone
(970) 668-3300
Fax
(978) 668-8123
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21960 CO Primary

Addresses

Primary practice location

Highway 9 and School Road
Frisco, CO 80443

Mailing address

PO Box 1225
Silverthorne, CO 80498-1225
Phone (970) 668-0895

Other identifiers 1

IdentifierTypeStateIssuer
01219609MedicaidCO

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21960COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breckenridge Medical Clinic, LLC Emergency Medicine Past Accepting new patients
Apex Emergency Group, Inc Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220659200000",
    "number": "1639143753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1225",
            "city": "SILVERTHORNE",
            "state": "CO",
            "postal_code": "804981225",
            "telephone_number": "970-668-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 9 AND SCHOOL ROAD",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-3300",
            "fax_number": "978-668-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROSEANNE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2008-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "21960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01219609",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.