Individual provider Active NPI

Mark A Shaw, BC-HIS

  • Hearing Instrument Specialist
  • Escondido, CA
National Provider Identifier
1639462013
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA531 Issued in CA
Practice address
925 E Pennsylvania Avenue
Suite H
Escondido, CA 92025
Phone
(760) 743-5544
Fax
(760) 743-5306
NPI assigned
May 18, 2011
Last updated
Mar 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA531 CA Primary

Addresses

Primary practice location

925 E Pennsylvania Avenue
Suite H
Escondido, CA 92025

Mailing address

925 E Pennsylvania Avenue
Suite H
Escondido, CA 92025
Phone (760) 743-5544

Other identifiers 1

IdentifierTypeStateIssuer
1194897496OtherCAMEDI-CAL

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

State licenses

LicenseStateTypeSpecialty
HA531CAMDHearing Instrument Specialist

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, 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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1639462013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E PENNSYLVANIA AVENUE",
            "address_2": "SUITE H",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "760-743-5544",
            "fax_number": "760-743-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E PENNSYLVANIA AVENUE",
            "address_2": "SUITE H",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "760-743-5544",
            "fax_number": "760-743-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "BC-HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "1194897496",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.