Paul Eric Shattuck, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101239166 Issued in VA

Practice address

1 Science CT
Madison, WI 53711-1055

Phone

(608) 280-7059

Fax

(608) 284-6375

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1902868300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 OVERLOOK TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052254",
            "telephone_number": "608-284-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCIENCE CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111055",
            "telephone_number": "608-280-7059",
            "fax_number": "608-284-6375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Overlook Ter",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537052254",
            "country_code": "US",
            "telephone_number": "608-284-6360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHATTUCK",
        "first_name": "PAUL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101239166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kami Grace Sharpe
• Ryan Sharpee, DPT
• Russell Sharpswain, DO
• Nicky Sharrow, RPH
• Jessica Shattuck, MSW
• Sarah A Shatz, MSW, APSW
• Nathaniel Shaver, RDN
• Bobbie Harte Shaw, MS LMFT
• Marsha Shaw, MSSW
• Robert Shaw, M.D.

• Internal Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.