Daniel D Shaw, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1065 Issued in ID

Practice address

290 W Georgia Ave
Nampa, ID 83686-2835

Phone

(208) 468-5970

Fax

(208) 463-3044

NPI assigned

Oct 21, 2005

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1649260654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W GEORGIA AVE",
            "address_2": "STE 115",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866811",
            "telephone_number": "208-463-3291",
            "fax_number": "208-463-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 W GEORGIA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862835",
            "telephone_number": "208-468-5970",
            "fax_number": "208-463-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DANIEL",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010149920",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "TC233",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00217946",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807145100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Clair Shafer
• Opal Michelle Shaffer, RN
• Megan A Shannahan, MS, SLP
• Erin Sharkey, MS
• Shaun Christensen, DMD, PC
• Shelby Spangler Counseling
• Kailey Rose Sheldon
• Tiffany Shelton
• Aimee Elizabeth Shepard, FNP-C
• Jacqueline Sherwood, LCSW

• Physical Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.