JEFFREY L SHAW (NPI# 1124083712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124083712 |
| Entity Type | Individual |
| Full Name | JEFFREY L SHAW |
| Credential | MD |
| Practice Address |
1821 S Webster Ave Green Bay WI 54301 |
| Mailing Address |
Po Box 19070 Green Bay WI 54307-9070 |
| Practice Telephone | 9204964700 |
| Practice Fax Number | 9204311914 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 42113-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207K00000X | Allergy & Immunology | 20844 | WV | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 20884 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2324505 | 05 | |
| KY | 64049158 | 05 | |
| WV | 1840670000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730577073 | Jeffrey Shaw | Counselor | 3098 Glen Laurel Ln, Winston Salem, NC 27107-4454 | 2015-01-08 |
| 1851518955 | Jeffrey Henry Shaw | Pediatrics | 1150 Chapman Ln Unit 25, Medina, OH 44256-6714 | 2007-04-19 |
| 1033253059 | Jeffrey K. Shaw | Chiropractor | 2044 S Airport Rd W, Traverse City, MI 49684-4711 | 2007-02-16 |
| 1962593483 | Jeffrey Stephen Shaw | Psychologist | 25 Sutton Pl S Apt 17a, New York, NY 10022-2460 | 2006-09-28 |
| 1871765321 | Jeffrey S Shaw | Dentist | 3311 Glendale Blvd, Los Angeles, CA 90039-1812 | 2008-03-25 |
| 1003955964 | Jeffrey W Shaw | Chiropractor | 60 2nd St, Granby, CO 80446-0036 | 2007-02-06 |
| 1316099435 | Jeffrey Allen Shaw | Clinical Neuropsychologist | 12303 Ne 130th Ln, Sutie 325, Kirkland, WA 98034-3099 | 2007-01-17 |
| 1396768107 | Jeffrey B Shaw | Family Medicine | 935 State Route 28, Milford, OH 45150-1911 | 2006-07-25 |
| 1114994456 | Jeffrey N Shaw | Anesthesiology | 800 E 28th St, Minneapolis, MN 55407-3723 | 2006-03-07 |
| 1326038399 | Jeffrey Gordon Shaw | Genetic Counselor, MS | 2222 N Nevada Ave, Cancer Administration, Colorado Springs, CO 80907-6831 | 2005-10-21 |
| Street Address |
1821 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091679 | Jerald P Marifke | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2005-05-24 |
| 1144858713 | Dawn P Mccullough | Nurse Practitioner | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2020-03-30 |
| 1881230266 | Kasey Jankowski | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2019-11-21 |
| 1699247486 | Erin Joanne Broda | Advanced Practice Midwife | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-12-18 |
| 1467928440 | Ashley Naas | Physical Therapist | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-10-17 |
| 1689167942 | Marissa Adrian | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-06-12 |
| 1427585736 | Nicole Will | Physical Medicine & Rehabilitation | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2017-05-17 |
| 1588111215 | Jennifer Gibbons | Registered Nurse | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-09-11 |
| 1639520414 | Lauren Isabel Useem | Obstetrics & Gynecology | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-06-23 |
| 1437506110 | Jessica Zarzecki | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366475253 | Joseph George Zondlo | Allergy & Immunology | 2333 Riverside Dr., Green Bay, WI 54301 | 2006-07-07 |
| 1548238850 | Victoria M Mcmeen | Allergy & Immunology | 519 S Monroe Ave, Green Bay, WI 54301-4017 | 2006-03-11 |
| 1316286941 | Bellin Memorial Hospital Inc | Allergy & Immunology | 519 S Monroe Ave, Green Bay, WI 54301-4017 | 2013-02-01 |
| 1306869276 | Prevea Clinic, Inc. | Allergy & Immunology | 2710 Executive Dr, Green Bay, WI 54304-5496 | 2006-07-25 |
| 1720034515 | James R. Warpinski | Allergy & Immunology | 519 S Monroe Ave, Green Bay, WI 54301-4017 | 2006-05-25 |
| 1215982368 | Alan W James | Allergy & Immunology | 519 S Monroe Ave, Green Bay, WI 54301-4017 | 2006-05-24 |
| 1720031024 | Center for Asthma & Allergy, Inc. | Allergy & Immunology | 519 S Monroe Ave, Green Bay, WI 54301-4017 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922167402 | Green Bay Allergy Asthma & Immunology S.c. Oconto | Allergy & Immunology | 203 Smith Ave Ste 1, Oconto, WI 54153-1060 | 2006-12-08 |
| 1518032325 | Allergy and Asthma Associates, Sc | Allergy & Immunology | 436 - B East Longview Drive, Appleton, WI 54911 | 2006-11-21 |
| 1982712204 | Mark A Huftel | Allergy & Immunology | 2727 Plaza Drive, Wausau, WI 54401 | 2006-08-27 |
| 1477660009 | Allergy Research & Care Sc | Allergy & Immunology | 350 Green Tree Road, Glendale, WI 53217-3815 | 2006-08-23 |
| 1609898287 | Allergic Diseases Sc | Allergy & Immunology | 11121 West Oklahoma Avenue, West Allis, WI 53227 | 2006-07-24 |
| 1952333510 | Kulwant Singh Dhaliwal | Allergy & Immunology | 4906 39th Ave, Kenosha, WI 53144-2108 | 2006-07-06 |
| 1790720613 | Prohealth Care Medical Associates, Inc. | Allergy & Immunology | N17w24100 Riverwood Dr, Prohealth Care Medical Associates, Inc., Waukesha, WI 53188-1177 | 2006-06-17 |
| 1356393292 | Morton Soifer | Allergy & Immunology | 9466 N Broadmoor Rd, Bayside, WI 53217-1309 | 2006-05-17 |
| 1336192061 | Daniel F Wendelborn | Allergy & Immunology | 436 B East Longview Drive, Appleton, WI 54911 | 2006-05-17 |
| 1477503670 | Karen R Konz | Allergy & Immunology | 436b E Longview Dr, Appleton, WI 54911 | 2006-05-11 |
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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.