Phillip Allen Shaw, M.ED., A.T.C.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

J00150 Issued in LA

Practice address

681 Highway 594
Monroe, LA 71203-8900

Phone

(318) 381-0140

NPI assigned

Sep 23, 2010

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1912215906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 OAK TRL",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712039672",
            "telephone_number": "318-381-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 HIGHWAY 594",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038900",
            "telephone_number": "318-381-0140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Warhawk Way",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712090001",
            "country_code": "US",
            "telephone_number": "318-342-5381",
            "fax_number": "318-342-3577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PHILLIP",
        "middle_name": "ALLEN",
        "credential": "M.ED., A.T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-23",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "J00150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisandhya Sharma, MD
• Sharp Minds
• Kelsey-Jo Sharpe, SLP, CBIS
• Linda Faye Sharpe
• Betsy Shaw, CIT
• Sharundolyn B Shaw
• Shaws Shuttle LLC
• SHC Medical Partners of Louisiana, LLC
• John Andrew Shealy, H.I.S
• Olivia Ann Shelby, RPH

• Athletic Trainer in Monroe, LA
• Providers in Monroe, LA by specialty
• Athletic Trainer in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; 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.