WILLIAM J SHAW IV (NPI# 1134258163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134258163 |
| Entity Type | Individual |
| Full Name | WILLIAM J SHAW IV |
| Credential | PA-C |
| Practice Address |
2901 Acme Brick Plz Fort Worth TX 76109-4124 |
| Practice Telephone | 8175291900 |
| Practice Fax Number | 8175291910 |
| Mailing Telephone | 8175291900 |
| Mailing Fax Number | 8175291910 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA04686 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366987588 | William Barnaby Shaw | Behavior Technician | 79 Poplar St, Apt 15, Roslindale, MA 02131-2506 | 2016-12-24 |
| 1073872586 | William H. Shaw | Urology | 5670 Vintage Oaks Circle, Delray Beach, FL 33484 | 2012-05-04 |
| 1730149550 | William E Shaw Jr. | Ophthalmology | 152 N Addison Ave Fl 1, Elmhurst, IL 60126-2821 | 2006-03-24 |
| 1689652133 | William E Shaw Jr. | Physician Assistant | 215 E 1st St Ste 326, Dixon, IL 61021-3190 | 2006-01-05 |
| 1750386280 | William E Shaw | Dentist | 531 Fond Du Lac Ave, Fond Du Lac, WI 54935-5441 | 2005-06-21 |
| 1316450125 | William Alton Shaw | Nurse Practitioner | 213 Caldwell Dr, Hazlehurst, MS 39083-2711 | 2017-11-15 |
| 1801265236 | William David Shaw | Behavioral Analyst | 312 Whitwell Dr, Roanoke, VA 24019-2039 | 2015-09-16 |
| 1417344011 | William Shaw | Physical Medicine & Rehabilitation | 1125 Madison St, Jefferson City, MO 65101-5227 | 2015-04-21 |
| 1699058628 | William Bradley Shaw | Chiropractor | 479 E 500 S, Salt Lake City, UT 84111-3312 | 2011-09-26 |
| 1255636148 | William Shaw | Marriage & Family Therapist | 2115 County Road D E, Suite B, Maplewood, MN 55109-5353 | 2011-01-24 |
| Street Address |
2901 ACME BRICK PLZ |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76109-4124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669419743 | Michael H Boothby | Orthopaedic Surgery | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2006-05-31 |
| 1043865157 | Heather Markgraf | Occupational Therapist | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2019-08-06 |
| 1417502790 | Andrew Sena Nfodjo | Physical Therapist | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2019-08-05 |
| 1861047276 | Caitlyn Johnson | Occupational Therapist | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2019-08-04 |
| 1598241952 | Margaret Ann Landon | Physician Assistant | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2018-07-18 |
| 1992221469 | Lance Wayne Bernard | Specialist/Technologist | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2017-08-16 |
| 1376081976 | Rachel Romack | Physician Assistant | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2017-02-03 |
| 1821354119 | Bret Beavers | Orthopaedic Surgery | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2012-04-11 |
| 1447555891 | William Garrett York | Physical Therapist | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2011-01-17 |
| 1295961233 | Gregory Todd Moore, Do Pa | Orthopaedic Surgery | 2901 Acme Brick Plz, Fort Worth, TX 76109-4124 | 2009-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881156164 | Elizabeth Laborde Dds Pllc | Clinic/Center | 5656 Edwards Ranch Rd, Fort Worth, TX 76109 | 2019-04-04 |
| 1992273965 | Debra Cooper Lantz | Occupational Therapist | 4252 Bryant Irvin Road, Fort Worth, TX 76109 | 2018-11-08 |
| 1417434119 | Dermatology Specialists of Fort Worth Pllc | Dermatology | 6100 Southwest Blvd., Suite 100, Fort Worth, TX 76109 | 2018-07-25 |
| 1417446709 | Eating Recovery Center of Texas, LLC | Clinic/Center | 4200 S. Hulen Street, Suite #436, Ft. Worth, TX 76109 | 2018-05-02 |
| 1245751742 | Marissa Izabel San Miguel | Optometrist | 5912 Convair Dr Ste 208, Fort Worth, TX 76109 | 2017-07-05 |
| 1174910111 | Parkway Dental Professionals | Preferred Provider Organization | 4200 Bryant Irvin Rd. Ste. 101, Fort Worth, TX 76109 | 2015-04-16 |
| 1831583095 | Deborah K Lehmann, M.d. | Clinic/Center | 6420 Southwest Blvd., #128, Fort Worth, TX 76109 | 2015-03-26 |
| 1184036428 | Ft Worth Ranch Assist, LLC | Neurological Surgery | 3516 Ranch View Terrace, Fort Worth, TX 76109 | 2014-05-21 |
| 1821435538 | Metx LLC | Hearing Instrument Specialist | 4618 Sw Loop 820, Fort Worth, TX 76109 | 2013-06-04 |
| 1356608087 | Virginia Flores | Social Worker | 4208 Ranier Ct, Fort Worth, TX 76109 | 2012-04-19 |
| Find all providers in zip 76109 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1629681952 | Anum Bashwani | Physician Assistant | 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 | 2020-08-26 |
| 1780200881 | Emily Brown Holloway | Physician Assistant | 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 | 2020-06-24 |
| 1679196570 | Maria Cristela Mosso | Physician Assistant | 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 | 2020-05-26 |
| 1679195978 | Jacob Torre | Physician Assistant | 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 | 2020-05-11 |
| 1871122382 | Kenaud Jeune | Physician Assistant | 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 | 2020-04-06 |
| 1922635648 | Lauren Elizabeth Studey | Physician Assistant | 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 | 2020-03-24 |
| 1033743612 | James Bregg Reedy | Physician Assistant | 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 | 2020-02-24 |
| 1992335194 | Alexandria Christine Rios | Physician Assistant | 5904 Rockhill Rd, Fort Worth, TX 76112-3047 | 2020-01-16 |
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76109 |
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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.