MR. JERRY EMERSON SHAW (NPI# 1265619118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265619118 |
Entity Type | Individual |
Full Name | MR. JERRY EMERSON SHAW |
Credential | PA-C |
Practice Address |
3980 New Covington Pike Ste 200 Memphis TN 38128-2514 |
Mailing Address |
5705 Stage Rd Ste 240 Bartlett TN 38134-4541 |
Practice Telephone | 9019373232 |
Practice Fax Number | 9013730804 |
Mailing Telephone | 9013822606 |
Mailing Fax Number | 9013730809 |
Enumeration Date | 2008-01-23 |
Last Update Date | 2009-09-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
815 | TN | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821452368 | Jerry Shaw | Pharmacist | 208 N Parkway Dr, Alvarado, TX 76009-3716 | 2016-04-11 |
1508877515 | Jerry L Shaw | Dentist | 1761 N 2000 W, Farr West, UT 84404 | 2006-08-11 |
1336186717 | Jerry Lee Shaw | Physical Therapist | 2000 Pepperell Pkwy, Opelika, AL 36801-5452 | 2006-06-02 |
Street Address |
3980 NEW COVINGTON PIKE STE 200 |
City | MEMPHIS |
State | TN |
Zip Code | 38128-2514 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518505775 | Available Home Care Service | Home Health | 3133 Kirkcaldy Rd, Memphis, TN 38128 | 2019-12-18 |
1912545690 | Sherry L. Russell | Technician | 4687 Priscilla Ave, Mmphis, TN 38128 | 2019-12-13 |
1518442318 | Genevieve Tempy Thomas | Counselor | 3900 Covington Pike, Suite 107, Memphis, TN 38128 | 2018-09-27 |
1487172037 | Right Care Home Health Agency | Home Health | 5116 Raleigh Lagrange Suite 5, Memphis, TN 38128 | 2017-09-05 |
1659744555 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 5020 English Towne Drive, Memphis, TN 38128 | 2015-11-02 |
1184009649 | Linda Fay Williams | Nurse Practitioner | 3655 Haughton Lane #2, Memphis, TN 38128 | 2015-07-27 |
1194153528 | Jessica Rene Bush | Social Worker | 2922 Covington Pike, Memphis, TN 38128 | 2013-10-22 |
1013345685 | Frank Earl Madden Sr. | Non-emergency Medical Transport (VAN) | 4416 E. Hunters Glen St, Memphis, TN 38128 | 2013-10-17 |
1902230915 | Jonathan Jeu | Pharmacist | 3500 Ramill Road, Memphis, TN 38128 | 2013-08-27 |
1245662238 | D&s Residential Services, Lp | Intermediate Care Facility, Mentally Retarded | 3131 James Road, Memphis, TN 38128 | 2013-08-01 |
Find all providers in zip 38128 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568910560 | Erica Troia Comstock | Physician Assistant | 7193 Farnham Rd, Memphis, NY 13112-8764 | 2016-09-19 |
1578895546 | Carl H. Harris | Physician Assistant | 6946 Finch Rd, Memphis, TN 38141-8598 | 2010-02-02 |
1831361948 | F & P Certified Surgical Assistants LLC | Physician Assistant | 4793 Northwood Hills Cv, Memphis, TN 38128-1632 | 2008-03-28 |
1508974700 | Mary E Bruce | Physician Assistant | 890 Madison Ave, Memphis, TN 38103-3409 | 2006-08-28 |
1427683796 | Madison Barry | Physician Assistant | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2020-03-07 |
1891340154 | Lauren Elizabeth Whitley | Physician Assistant | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2019-08-05 |
1518519057 | Michael Trevor Houseal | Physician Assistant | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2019-07-15 |
1427571850 | Kristen Kaplon | Physician Assistant | 6029 Walnut Grove Rd Ste 401, Memphis, TN 38120-2112 | 2017-07-18 |
1316485667 | Kathryn Lee | Physician Assistant | 6025 Walnut Grove Rd Ste 301, Memphis, TN 38120-2123 | 2017-02-07 |
1700331527 | Ted James Hegner | Physician Assistant | 6005 Park Ave Ste 802, Memphis, TN 38119-5218 | 2016-08-22 |
Find all providers in MEMPHIS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.