Active NPI
Charles H Shaw, M.D.
- Specialist
- Mansfield, OH
National Provider Identifier
1982623583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 35-04-5931
- Practice address
- 370 Cline Avenue
Mansfield, OH 44907 - Phone
- (419) 756-8511
- Fax
- (419) 756-8513
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 35-04-5931 | OH | Primary |
Addresses
Primary practice location
370 Cline Avenue
Mansfield, OH 44907
Mailing address
4457 Possum Run Road
Bellville, OH 44813
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0563840 | Medicaid | OH | |
| 000000025568 | Other | OH | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1982623583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4457 POSSUM RUN ROAD",
"city": "BELLVILLE",
"state": "OH",
"postal_code": "44813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 CLINE AVENUE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44907",
"telephone_number": "419-756-8511",
"fax_number": "419-756-8513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "CHARLES",
"middle_name": "H",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "35-04-5931",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0563840",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000025568",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.