Individual provider Active NPI

Neil Shaw, NP

  • Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1881045896
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704286192 Issued in MI
Practice address
1200 Sixth St Ste 200
Traverse City, MI 49684
Phone
(231) 935-5800
Fax
(231) 935-5799
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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 4704286192 MI Primary

Addresses

Primary practice location

1200 Sixth St Ste 200
Traverse City, MI 49684

Mailing address

224 Circle Dr
Traverse City, MI 49684-2700
Phone (231) 932-4912

Other practice location 1

617 N Court Ave
Gaylord, MI 49735-1515
Phone (989) 731-9532

Other practice location 2

809 E Michigan Ave
Grayling, MI 49738-1417
Phone (989) 348-0530

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nshaw2@direct.mhc.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171211002704 MI Practitioner - Nurse Practitioner 7315205879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

1200 6TH St
Suite 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Nov 8, 2017 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Group CurrentSince Nov 8, 2017 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

617 N Court Ave
Gaylord, MI 49735
Phone (989) 731-9532

829 N Center Ave
Ste 110
Gaylord, MI 49735
Phone (989) 731-9532

809 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0530

224 Circle Dr
Traverse City, MI 49684
Phone (231) 932-4912

1200 Sixth St
Ste 200
Traverse City, MI 49684

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 7

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1881045896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CIRCLE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842700",
            "telephone_number": "231-932-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 N Court Ave",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351515",
            "country_code": "US",
            "telephone_number": "989-731-9532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497381417",
            "country_code": "US",
            "telephone_number": "989-348-0530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "NEIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704286192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nshaw2@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1200 Sixth St Ste 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.