Active NPI
Susan Shaw, M.D.
- Neurology Physician
- Baltimore, MD
National Provider Identifier
1972702181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A90788
- Practice address
- 600 N Wolfe St
Meyer 2-147
Baltimore, MD 21287-0005 - Phone
- (410) 502-3415
- NPI assigned
- Jul 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | A90788 | CA | Primary |
Addresses
Primary practice location
600 N Wolfe St
Meyer 2-147
Baltimore, MD 21287-0005
Mailing address
600 N Wolfe St
Meyer 2-147
Baltimore, MD 21287-0005
Phone (410) 502-3415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091021000611 | CA | Practitioner - Neurology | 0941347009 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A90788 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239580800000",
"number": "1972702181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"address_2": "MEYER 2-147",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-502-3415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"address_2": "MEYER 2-147",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-502-3415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "SUSAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-17",
"last_updated": "2009-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A90788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.