Individual provider Active NPI

Aaron D Shaw, ARNP

  • Nurse Practitioner
  • Pittsburg, KS
National Provider Identifier
1669564787
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45780 Issued in KS
Practice address
100 N Pine St
Pittsburg, KS 66762-4744
Phone
(620) 231-3750
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45780 KS Primary

Addresses

Primary practice location

100 N Pine St
Pittsburg, KS 66762-4744

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (620) 231-3750

Other identifiers 3

IdentifierTypeStateIssuer
463278MedicaidKS
161797OtherKSBCBS
481209286OtherKSTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110406000794 KS Practitioner - Nurse Practitioner 7113101775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians
Community Health Center of Southeast Kansas IncGroup PAC ID 7911816392, 111 clinicians

Practice addresses (Care Compare)

100 N Pine St
Pittsburg, KS 66762-4756
Phone (620) 231-3750

1017 E Market St
La Cygne, KS 66040-9102
Phone (913) 757-4575

3011 N Michigan St
Pittsburg, KS 66762-2546
Phone (620) 231-9873

3015 N Michigan St
Pittsburg, KS 66762-2546

Hospital & facility affiliations

  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137
  • Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
45780KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Southeast Kansas Inc CurrentSince Mar 8, 2014 Accepting new patients
Community Health Center of Southeast Kansas Inc CurrentSince Mar 8, 2014 Accepting new patients
Community Health Center of Southeast Kansas, Inc Past Accepting new patients

Locations

1017 E Market St
Lacygne, KS 66040
Phone (913) 757-4575

100 N Pine St
Pittsburg, KS 66762
Phone (620) 231-3750

3011 N Michigan St
Pittsburg, KS 66762
Phone (620) 231-1960

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1669564787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "620-231-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N PINE ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667624744",
            "telephone_number": "620-231-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AARON",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463278",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "161797",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "481209286",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.