Vernon Allen Shaw, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23001343A Issued in IN

Practice address

99 E 86TH Ave
Merrillville, IN 46410-6381

Phone

(219) 738-2617

Fax

(219) 738-2145

NPI assigned

Jan 18, 2006

Last updated

Jul 22, 2019By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Southlake Speech & Hearing Center, Inc

  • Audiologist
  • Merrillville, IN
  • NPI 1609943380
  NPD (past)
• Primesource Healthcare Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1801008644
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1700866506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E 86TH AVE STE A",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106267",
            "telephone_number": "219-738-2528",
            "fax_number": "219-738-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E 86TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106381",
            "telephone_number": "219-738-2617",
            "fax_number": "219-738-2145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Waukegan Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600154342",
            "country_code": "US",
            "telephone_number": "800-317-0711 x5954",
            "fax_number": "800-434-7113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "VERNON",
        "middle_name": "ALLEN",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23001343A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000288063",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon McCarthy MD Inc
• Breanna Patrice Shannon
• Kyra Shannon
• Alicia Sharkey, RBT
• Debra Shaw, RBT
• Kelsey Shelhart
• Brittany Shelton
• Sara Shelton, RBT
• Elian Michael Shepherd, M.D.
• Katelyn Marie Sherman, SLP

• Audiologist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Audiologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.