Individual provider Active NPI

Ronald Steven Shaw, D.C.

  • Chiropractor
  • Victorville, CA
National Provider Identifier
1902047202
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-31188 Issued in CA
Practice address
12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone
(760) 684-4143
Fax
(760) 684-8111
NPI assigned
Mar 16, 2009
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-31188 CA Primary

Addresses

Primary practice location

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753

Mailing address

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110714000576 CA Practitioner - Chiropractic 8921276189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12640 Hesperia Rd
Suite D
Victorville, CA 92395-7753
Phone (760) 684-4143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moeller-Bertram Medical Corporation CurrentSince May 1, 2025 Accepting new patients
Tobias Moeller-Bertram MD Corporation CurrentSince Mar 31, 2025 Accepting new patients
Steven Shaw Chiropractic Inc. Chiropractor Current Accepting new patients
Tobias Moeller-Bertram MD Corporation CurrentSince Mar 31, 2025 Accepting new patients
Goldstein Chiropractic Inc Chiropractor Past Accepting new patients
La Health & Wellness Medical Group PastSince Apr 4, 2017 Accepting new patients

Locations

44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290

36101 Bob Hope Dr
Ste A
Rancho Mirage, CA 92270
Phone (760) 321-1315

36101 Bob Hope Dr
Ste A1
Rancho Mirage, CA 92270
Phone (760) 321-1315

12640 Hesperia Rd
Ste D
Victorville, CA 92395
Phone (760) 684-4143

12830 Hesperia Rd
Ste Ad
Victorville, CA 92395
Phone (760) 684-8999

12830 Hesperia Rd
Ste C
Victorville, CA 92395
Phone (760) 684-8999

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1902047202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4143",
            "fax_number": "760-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4143",
            "fax_number": "760-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "RONALD",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-16",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.