Individual provider Active NPI

Natalie Wilson Shaw, AU.D.

  • Audiologist
  • Elizabethtown, KY
National Provider Identifier
1639376668
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0484 Issued in KY
Practice address
580 Westport Rd # B
Elizabethtown, KY 42701-2949
Phone
(270) 765-6982
NPI assigned
Jul 2, 2007
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0484 KY Primary

Addresses

Primary practice location

580 Westport Rd # B
Elizabethtown, KY 42701-2949

Mailing address

3815 Ormond Rd
Louisville, KY 40207-1902
Phone (270) 804-0658

Other names 1

  • Dr. Natalie Marie Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090717000622 KY Practitioner - Qualified Audiologist 5698827830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0484KYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Leider MD PLLC CurrentSince May 11, 2024 Accepting new patients
Jeffrey Leider MD PLLC Audiologist CurrentSince May 11, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1639376668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 ORMOND RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071902",
            "telephone_number": "270-804-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 WESTPORT RD # B",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012949",
            "telephone_number": "270-765-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "NATALIE",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "0484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "WILSON",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.