Jonathan David Shaw, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

36677 Issued in TN

Practice address

2911 Brunswick Road
Memphis, TN 38133

Phone

(901) 377-4700

NPI assigned

Sep 19, 2006

Last updated

Jun 1, 2018By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Alliance Healthcare Services

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1295898393
  Medicare reassignment NPD
• Alliance Healthcare Services

  dba Alliance Healthcare System Whitney Pharmacy

  • Clinic Pharmacy
  • Memphis, TN
  • NPI 1912312828
  NPD
• Bethesda Health Services, LLC

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1407244171
  NPD (past)
• State of Tennessee State F & a Payroll

  dba Memphis Mental Health Institute

  • Psychiatric Hospital
  • Memphis, TN
  • NPI 1457435893
  NPD (past)
• Youth Villages, Inc.

  • Community/Behavioral Health Agency
  • Bartlett, TN
  • NPI 1306875695
  NPD (past)

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1669579116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000 MSC7548",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372417548",
            "telephone_number": "901-377-4700",
            "fax_number": "901-377-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 BRUNSWICK ROAD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38133",
            "telephone_number": "901-377-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "36677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q008619",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00877855",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arie C Shaw, M.D.
• Ashley Shaw
• Camden Faith Studstill Shaw, DNP, CPNP-AC/PC
• Gregory Don Shaw II, D.V.M.
• Jerry Emerson Shaw, PA-C
• Leslie Shaw
• Maria Lynette Shaw, RRT
• Rachel D Shaw
• Shundonna S Shaw, FNP-BC
• Triphine Shaw

• Child & Adolescent Psychiatry Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Child & Adolescent Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.