KEVIN B SHAW (NPI# 1639193105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639193105 |
| Entity Type | Individual |
| Full Name | KEVIN B SHAW |
| Credential | LCP |
| Practice Address |
109 W 2nd St Ottawa KS 66067-2212 |
| Mailing Address |
1953 Reno Rd Ottawa KS 66067-8754 |
| Practice Telephone | 7852422991 |
| Practice Fax Number | 7852424401 |
| Mailing Telephone | 7852428059 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2008-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
------ | KS | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
065 | KS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770692550 | Kevin Michael Shaw | Chiropractor | 94 High St, Newton, NJ 07860-1721 | 2006-08-29 |
| 1073009759 | Kevin Shaw | Physical Therapist | 2575 Peachtree Pkwy, Cumming, GA 30041-7559 | 2018-07-06 |
| 1851885362 | Kevin Shaw | Counselor | 2531 W Woodland Dr, Anaheim, CA 92801-2637 | 2018-06-18 |
| 1760742928 | Kevin Thomas Shaw | Hospitalist | 565 Coal Valley Rd, Jefferson Hills, PA 15025-3703 | 2012-05-22 |
| 1881865202 | Kevin Shaw | Occupational Therapist | 3101 37th Ave N, Suite A, St Petersburg, FL 33713-1509 | 2008-03-13 |
| 1659570893 | Kevin D Shaw | Acupuncturist | 2804 Grand Ave, Suite 300, Everett, WA 98201-3430 | 2007-07-17 |
| 1154520864 | Kevin Daniel Shaw | Internal Medicine | 200 W Arbor Dr, San Diego, CA 92103-9001 | 2007-07-12 |
| 1861699563 | Kevin Shaw | Counselor | 2577 Ne Courtney Dr, Bend, OR 97701-7638 | 2007-06-27 |
| 1639185770 | Kevin J Shaw | Orthopaedic Surgery | 8099 Cornell Rd, Cincinnati, OH 45249-2231 | 2006-07-31 |
| 1497741862 | Kevin Matthew Shaw | Anesthesiology | 99 E River Dr, 5th Floor, East Hartford, CT 06108-3288 | 2005-09-21 |
| Street Address |
109 W 2ND ST |
| City | OTTAWA |
| State | KS |
| Zip Code | 66067-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205076759 | Recovery Services Center | Clinic/Center | 109 W 2nd St, Ottawa, KS 66067-2212 | 2009-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482870 | Katie Jean Turpin | Occupational Therapist | 3901 S Main St, Ottawa, KS 66067 | 2020-03-18 |
| 1619526464 | Jennifer Raybern | Specialist/Technologist | 1001 S Cedar St, Ottawa, KS 66067 | 2019-09-04 |
| 1508419938 | Custom Dental of Ottawa, Pa | Clinic/Center | 2030 S Princeton St, Ottawa, KS 66067 | 2019-07-24 |
| 1861948507 | Jeffrey Byrne Kelley | Pharmacist | 2101 S Princeton Rd, Ottawa, KS 66067 | 2016-09-01 |
| 1619185188 | Vintage Park At Ottawa LLC | Assisted Living Facility | 2250 S Elm St, Ottawa, KS 66067 | 2007-05-18 |
| 1356423495 | Ottawa Oral Surgery Lc | Dentist | 107 E 23rd St, Ste 3 Ottawa Oral Surgery Lc, Ottawa, KS 66067 | 2006-10-19 |
| 1669564332 | Sandra K Staneart | Nurse Practitioner | 1302 South Main St, Suite 1, Ottawa, KS 66067 | 2006-09-29 |
| 1467553214 | Nancy L Pauw | Social Worker | 2476 Reno Rd, Ottawa, KS 66067 | 2006-09-26 |
| 1700847043 | T.a. Rainbolt, Dds, P.a. | Dentist | 1334 S. Main Street, Ottawa, KS 66067 | 2006-03-28 |
| 1659341634 | Milton Laverne Sampson | Nurse Anesthetist, Certified Registered | 1301 S Main, Ottawa, KS 66067 | 2006-01-24 |
| Find all providers in zip 66067 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345906 | Thrive Collective | Psychologist | 1400 State St, Ottawa, IL 61350-4735 | 2020-11-01 |
| 1710473202 | Melissa Terry | Psychologist | 1400 State St, Ottawa, IL 61350-4735 | 2018-07-08 |
| 1952453003 | Robert Eugene Friedle | Psychologist | 1614 E Norris Dr, Ottawa, IL 61350-3681 | 2007-01-17 |
| 1306916077 | Andrew Lawrence Whitmore | Psychologist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2006-11-09 |
| 1376635284 | Michael L Fowler | Psychologist | 204 E 15th St, Ottawa, KS 66067-3903 | 2006-09-28 |
| 1194758946 | Dana Rene' Paquette | Psychologist | 204 E 15th St, Ottawa, KS 66067-3903 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785852 | Freudhawk Psychological Enterprises, LLC | Psychologist | 1307 E Iron Ave, Salina, KS 67401-3231 | 2020-06-23 |
| 1750914321 | Brian Patrick Russell | Psychologist | 730 New Hampshire St Ste 3m, Lawrence, KS 66044-3174 | 2020-02-21 |
| 1700429982 | Carolyn Sue Pepper | Psychologist | 2614 S 25th St, Leavenworth, KS 66048-4338 | 2019-10-21 |
| 1992355143 | Peabody,inc. | Psychologist | 7381 W 133rd St Ste 203, Overland Park, KS 66213-4777 | 2019-09-18 |
| 1174097042 | Heidi Marie Pontinen | Psychologist | 1901 E First St., Newton, KS 67114-0467 | 2019-01-14 |
| 1295232015 | Connection Therapy, LLC | Psychologist | 309 Happy Hollow St, Vermillion, KS 66544-8633 | 2018-04-09 |
| 1902304116 | Psychological Health Services, LLC | Psychologist | 626 Nebraska Ave, Holton, KS 66436-1462 | 2018-01-23 |
| 1588182885 | Glen M. Harnden | Psychologist | 16970 Grandview St, Overland Park, KS 66085-9376 | 2017-09-07 |
| 1063938850 | Lindsey Marie Backer-fulghum | Psychologist | Wichita State University, Counseling & Testing Center, 1845 Fairmount St., Wichita, KS 67260-0091 | 2017-08-14 |
| 1861913659 | Janelle Jeffrey | Psychologist | 1013 W 8th St Ste A, Junction City, KS 66441-2281 | 2017-06-30 |
| Find all providers with the same taxonomy | ||||
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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.