JESSE DANIEL SHAW (NPI# 1912293572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912293572 |
| Entity Type | Individual |
| Full Name | JESSE DANIEL SHAW |
| Credential | D.O |
| Practice Address |
1401 25th St S Great Falls MT 59405-5183 |
| Practice Telephone | 4067318888 |
| Practice Fax Number | 4067318876 |
| Mailing Telephone | 4067318888 |
| Mailing Fax Number | 4067318876 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2019-06-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
75469 | MT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952718157 | Jesse Shaw | Pharmacist | 1090 S Main St, Kernersville, NC 27284-7440 | 2014-07-20 |
| 1396865788 | Jesse Shaw | Orthopaedic Surgery | 17779 Sw 2nd St, Pembroke Pines, FL 33029-3924 | 2007-03-30 |
| Street Address |
1401 25TH ST S |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405-5183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184625055 | Mary E Gray | Nurse Practitioner | 1401 25th St S, Great Falls, MT 59405-5183 | 2005-08-02 |
| 1104459718 | Katie Grace Smyth | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2020-02-21 |
| 1962973776 | Blanche Stutz | Nurse Practitioner | 1401 25th St S, Great Falls, MT 59405-5183 | 2018-12-06 |
| 1457828337 | Zale Kaupish | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2018-10-29 |
| 1245722735 | Jordan Elizabeth Hronek | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2018-05-31 |
| 1164932000 | Alyissa H Canady | Pharmacist | 1401 25th St S, Great Falls, MT 59405-5183 | 2017-10-05 |
| 1417466327 | Margaret Janelle Davenport | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2017-09-22 |
| 1588183321 | Andrew Koopman | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2017-09-13 |
| 1306364724 | Noelle Marie-lynn Steiner | Physician Assistant | 1401 25th St S, Great Falls, MT 59405-5183 | 2017-09-06 |
| 1982121760 | Melanie Marie Brown | Nurse Practitioner | 1401 25th St S, Great Falls, MT 59405-5183 | 2017-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780767616 | Paul M Johnson | Family Medicine | 1401 25th St S, Great Falls, MT 59405-5183 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811386220 | University of Montana | Family Medicine | 37 Campus Dr, Hoyt Complex, Missoula, MT 59812-0001 | 2015-01-22 |
| 1164083531 | Bozeman Sports Medicine, Inc. | Family Medicine | 117 E Oak St Ste 1a, Bozeman, MT 59715-2977 | 2019-06-25 |
| 1265691083 | Janna J Vilen | Family Medicine | 3150 N Montana Ave Ste A, Helena, MT 59602-7804 | 2008-06-06 |
| 1679759971 | Family Health Care PC | Family Medicine | 715 Nucleus Ave, Columbia Falls, MT 59912-4015 | 2008-01-16 |
| 1619166972 | Performance Injury Care & Sports Medicine, Inc. | Family Medicine | 3150 N Montana Ave, Suite A, Helena, MT 59602-7804 | 2007-10-23 |
| 1174546857 | Carla Catherine Fritz | Family Medicine | 2901 Brooks St, Missoula, MT 59801-7722 | 2006-07-25 |
| 1215969936 | Erik L Schroeder | Family Medicine | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2006-07-06 |
| 1982686804 | Royce G Pyette | Family Medicine | 1450 Ellis St, Suite 201, Bozeman, MT 59715-8812 | 2005-11-16 |
| City | GREAT FALLS |
| Zip Code | 59405 |
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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.