NPIMap

Individual provider Active NPI

Luke Philip Reine Shaw, DO

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1780848341
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008015988 Issued in MO
Practice address
2711 S Meadowbrook Ave
Springfield, MO 65807-5924
Phone
(417) 887-0081
Fax
(417) 227-1412
NPI assigned
Jul 14, 2008
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2008015988 MO Primary

Addresses

Primary practice location

2711 S Meadowbrook Ave
Springfield, MO 65807-5924

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 1

IdentifierTypeStateIssuer
1780848341MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000347 MO Practitioner - Family Practice 7012032261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

448 State Hwy 248
Suite 150
Branson, MO 65616-3725
Phone (417) 336-6713

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2008015988MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 25, 2019 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 1, 2011 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 1, 2011 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

448 State Highway 248
Ste 150
Branson, MO 65616
Phone (417) 336-6713

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1423 N Jefferson Ave
#B100
Springfield, MO 65802
Phone (417) 269-8817

1718 W Woodland St
Springfield, MO 65807
Phone (417) 887-0081

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2711 S Meadowbrook Ave
Springfield, MO 65807
Phone (417) 887-0081

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: lshaw192382@directb.mercy.net

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1780848341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 S MEADOWBROOK AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075924",
            "telephone_number": "417-887-0081",
            "fax_number": "417-227-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LUKE",
        "middle_name": "PHILIP REINE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2008015988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780848341",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.