Individual provider Active NPI

Thomas D Shaw, D.C.

  • Chiropractor
  • Ellicott City, MD
National Provider Identifier
1831218684
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S1501 Issued in MD
Practice address
10045 Baltimore National Pike
A-10
Ellicott City, MD 21042-3673
Phone
(410) 313-8325
Fax
(410) 313-9755
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S1501 MD Primary

Addresses

Primary practice location

10045 Baltimore National Pike
A-10
Ellicott City, MD 21042-3673

Mailing address

10045 Baltimore National Pike
A-10
Ellicott City, MD 21042-3673
Phone (410) 313-8325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1501MDMDClinical Psychologist
S1501MDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831218684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 BALTIMORE NATIONAL PIKE",
            "address_2": "A-10",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423673",
            "telephone_number": "410-313-8325",
            "fax_number": "410-313-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 BALTIMORE NATIONAL PIKE",
            "address_2": "A-10",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423673",
            "telephone_number": "410-313-8325",
            "fax_number": "410-313-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S1501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.