DR. TREVECCA KERRY SHAW (NPI# 1497917165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497917165 |
| Entity Type | Individual |
| Full Name | DR. TREVECCA KERRY SHAW |
| Credential | DPM |
| Practice Address |
1320 Belmont Ave #1 Youngstown OH 44504 |
| Mailing Address |
1320 Belmont Ave #1 Youngstown OH 44504-1130 |
| Practice Telephone | 3307473910 |
| Practice Fax Number | 3307473930 |
| Mailing Telephone | 3307473910 |
| Mailing Fax Number | 3307473930 |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2018-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
00338 | KY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM | 000000614278 | 01 | |
| OH | 2919864 | 05 |
| Street Address |
1320 BELMONT AVE #1 |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982678272 | David Michael Davis | Family Medicine | 1320 Belmont Ave, Suite #2, Youngstown, OH 44504-1130 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003458845 | Shay Kahani | Social Worker | 517 Gypsy Lane, Youngstown, OH 44504 | 2019-10-14 |
| 1497312573 | Parth Shah | Student in an Organized Health Care Education/Training Program | Western Reserve Health Education, 500 Gypsy Lane, Medical Office Building A, Youngstown, OH 44504 | 2019-05-23 |
| 1811455348 | Kisha Brady | Nurse Practitioner | 1350 Belmont Ave, Youngstown, OH 44504 | 2019-03-04 |
| 1750808473 | Janae White | Home Health | 2278 Cordova Ave, Youngstown, OH 44504 | 2017-08-23 |
| 1760910509 | Ryan Gallagher | Student in an Organized Health Care Education/Training Program | 1001 Covington Ave, Youngstown, OH 44504 | 2017-05-24 |
| 1649727314 | Bilal Abo Almakarim Kanawati | Specialist/Technologist, Other | 461 Gypsy Ln Apt 72, Youngstown, OH 44504 | 2016-09-09 |
| 1174979157 | Hiyam Abdelmagid | Internal Medicine | 1001 Covington Ave., Youngstown, OH 44504 | 2016-05-10 |
| 1962696419 | Earnest Perry, M.d., Inc. | Surgery | 1320 Belmont Avenue, Ste 2, Youngstonw, OH 44504 | 2007-08-28 |
| 1699839738 | Rodney Earl Hill | Family Medicine | 1350 Fifth Ave, Suite 324, Youngstown, OH 44504 | 2006-12-21 |
| 1710063987 | David A Hoffman | Internal Medicine | 1220 Belmont Avenue, Youngstown, OH 44504 | 2006-10-31 |
| Find all providers in zip 44504 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629261847 | Kyle Robert Wire | Podiatrist | 7558 Sugartree Dr, Youngstown, OH 44512-5430 | 2007-08-21 |
| 1649315037 | Associates Family Foot Care, LLC | Podiatrist | 3200 Belmont Ave, Youngstown, OH 44505-1862 | 2007-02-21 |
| 1720092182 | Associates Family Foot Care, LLC | Podiatrist | 32 Jacobs Rd, Youngstown, OH 44505-4908 | 2006-07-28 |
| 1891780599 | Vern Michael Chuba | Podiatrist | 819 Mccartney Rd, Youngstown, OH 44505-5047 | 2005-09-19 |
| 1992157788 | Derek Ley | Podiatrist | 8175 Market St, Youngstown, OH 44512 | 2016-07-06 |
| 1194189589 | Kiana Karbasi | Podiatrist | 1300 S Canfield Niles Rd, Youngstown, OH 44515-4081 | 2016-04-11 |
| 1194122903 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 1265 Boardman Canfield Rd, Youngstown, OH 44512-4004 | 2014-11-21 |
| 1407252984 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 8175 Market St, Youngstown, OH 44512-6244 | 2014-11-12 |
| 1508262908 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 5170 Belmont Ave, Youngstown, OH 44505-1022 | 2014-11-12 |
| 1487050886 | Ohio Podiatric Physicians and Surgeons Group, LLC | Podiatrist | 500 Gypsy Ln, Suite 201, Youngstown, OH 44504-1315 | 2014-11-12 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44504 |
Please comment or provide details below to improve the information on DR. TREVECCA KERRY SHAW.
| 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.