Bobby Shaw MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOBBY SHAW MD LLC

Practice address

2930 Siena Heights Dr
Henderson, NV 89052-3871

Phone

(702) 453-3799

Fax

(702) 453-5741

NPI assigned

Oct 29, 2019

Organization subpart

No

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

Authorized official

Name

Priya Shaw, M.D.

Title

Sole Owner

Phone

(702) 840-8674

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1992349369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 SAINT ROSE PKWY # 777905",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523889",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 SIENA HEIGHTS DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523871",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY SHAW MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "PRIYA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "702-840-8674",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alfred Body II

• Family Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.