Mark Cal Shaw, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD023225 Issued in LA

Practice address

402 Second St.
Bernice, LA 71222

Phone

(318) 285-9066

Fax

(318) 285-9065

NPI assigned

May 11, 2006

Last updated

Oct 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

University of Texas Medical School at Houston, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ess of Nacogdoches LLCGroup PAC ID 3375821630, 27 clinicians

Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Integrative Emergency Services Physician Group-Houston PLLCGroup PAC ID 7113258500, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshaw355385@ahs.direct-ci.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment Care Compare group NPD
• Ess of Nacogdoches LLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1780139956
  Medicare reassignment Care Compare group NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment Care Compare group NPD
• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment NPD
• Bonita Creek Emergency Services PLLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1902555485
  Medicare reassignment NPD
• Bernice Medical Associates,LLC

  • Family Medicine Physician
  • Bernice, LA
  • NPI 1831144021
  NPD (past)
• Hospital Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)
• Bonner Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Rusk, TX
  • NPI 1841469244
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jacksonville Hospital LLC

  dba UTHealth East Texas Jacksonville Hospital

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Nacogdoches County Hospital District

  dba NCHD Memorial Hospital

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1881644938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 HIDDEN VALLEY DR.",
            "city": "GARRISON",
            "state": "TX",
            "postal_code": "75946",
            "telephone_number": "936-715-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SECOND ST.",
            "city": "BERNICE",
            "state": "LA",
            "postal_code": "71222",
            "telephone_number": "318-285-9066",
            "fax_number": "318-285-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MARK",
        "middle_name": "CAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M9001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD023225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1495611",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payne Mays Enterprises (P-M Medical Transportation)
• Leu Anne Prince, LPC
• Quality Life Therapy Services LLC
• Allison Elise Roan, PT, DPT, CES
• Serenity Springs Nursing & Rehabilitation Center LLC
• Sara Maricle Slaton, APRN, FNP-C
• Caleb Benjamin Stanfield
• The Bernice Pharmacy Inc
• The Bernice Pharmacy Inc
• The Bernice Pharmacy Inc (Bernice Pharmacy-LTC)

• Family Medicine Physician in Bernice, LA
• Providers in Bernice, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.