Candice Vasquez Shaw, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2007028657 Issued in MO

Practice address

107 Concord Plaza
St. Louis, MO 63128-1307

Phone

(314) 842-2990

Fax

(314) 842-5162

NPI assigned

Dec 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Candice Ann Vasquez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: candice.shaw.p2@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1197763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1982887725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 BARRETT PARKWAY DRIVE",
            "address_2": "SUITE 105",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215896",
            "telephone_number": "314-821-9126",
            "fax_number": "314-821-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CONCORD PLAZA",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631281307",
            "telephone_number": "314-842-2990",
            "fax_number": "314-842-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "CANDICE",
        "middle_name": "VASQUEZ",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-16",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2007028657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "VASQUEZ",
            "middle_name": "ANN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Zelphia Shaw-Reese, F02180750
• Amy Michelle Shaw, RNC, NNP
• Angela Marie Shaw, MD
• Britain Laine Shaw
• Brooke A Shaw, BA, CLC
• David L Shaw, M.D.
• Jasmine Shaw
• Joshua Antoine Colin Shaw, MD
• Katherine Louis Shaw
• Kathryn Elizabeth Shaw, M.A., L.P.C.

• Physical Therapist in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.