CHARLOTTE B SHAW (NPI# 1316219751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316219751 |
| Entity Type | Individual |
| Full Name | CHARLOTTE B SHAW |
| Credential | PA-C |
| Practice Address |
510 S Washington St Bastrop LA 71220-5033 |
| Practice Telephone | 3182818110 |
| Practice Fax Number | 3182818099 |
| Mailing Telephone | 3182818110 |
| Mailing Fax Number | 3182818099 |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2014-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA200515 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | PA-C | PA200515 | 01 |
| LA | 2316729 | 05 |
| Street Address |
510 S WASHINGTON ST |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-5033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518525419 | Ashley Cheek | Nurse Practitioner | 510 S Washington St, Bastrop, LA 71220-5033 | 2019-06-05 |
| 1558646984 | Lauren Vyvial | Nurse Practitioner | 510 S Washington St, Bastrop, LA 71220-5033 | 2011-10-17 |
| 1871732669 | Delta Medical Practices, L.L.C. | Internal Medicine | 510 S Washington St, Bastrop, LA 71220-5033 | 2009-02-18 |
| 1669658571 | Sterlington Critical Access Hospital, L.L.C. | Clinic/Center | 510 S Washington St, Bastrop, LA 71220-5033 | 2008-01-10 |
| 1902089246 | Clinton A Netherland, Md Apmc | Family Medicine | 510 S Washington St, Bastrop, LA 71220-5033 | 2007-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780641621 | Anthony Young | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2006-04-26 |
| 1063796571 | Morehouse Internal Medicine Clinic | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2011-10-03 |
| 1265658025 | William Edward Mcmanus | Physician Assistant | 3101 Highway 71 E, Suite 101, Bastrop, TX 78602-5156 | 2007-04-18 |
| 1205859246 | Robert Leslie Schreiner | Physician Assistant | 441 Highway 71 W, Suite C, Bastrop, TX 78602-3931 | 2006-07-25 |
| 1447284021 | Carlos Hernandez | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2006-07-10 |
| 1265481501 | Diana Case | Physician Assistant | 301 Highway 71 W, Suite 111, Bastrop, TX 78602-4105 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174120307 | Olivia Hockenjos | Physician Assistant | 1000 Chinaberry Dr Ste 1200, Bossier City, LA 71111-2463 | 2020-10-01 |
| 1053928622 | Kennedy Poole | Physician Assistant | 1643 Carter St Ste 1, Vidalia, LA 71373-3157 | 2020-09-28 |
| 1699382176 | Morgan Prejean | Physician Assistant | 11445 Coursey Blvd Ste L, Baton Rouge, LA 70816-0411 | 2020-09-28 |
| 1972118776 | Emma W Bollich | Physician Assistant | 6703 Ambassador Caffery Pkwy Ste 2, Broussard, LA 70518-5283 | 2020-09-09 |
| 1316595937 | Antonia Colombo | Physician Assistant | 2705 Fable St, Meraux, LA 70075-2372 | 2019-08-27 |
| 1861058752 | Christina Daigle | Physician Assistant | 1057 Paul Maillard Rd Ste 2210, Luling, LA 70070-4349 | 2019-05-15 |
| 1376078022 | Brian Ammon | Physician Assistant | 11831 Oakwilde Ave, Baton Rouge, LA 70810-3120 | 2017-05-01 |
| 1912448036 | Christy Stoltz | Physician Assistant | 120 N Pinaud St, Saint Martinville, LA 70582-4732 | 2017-03-09 |
| 1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
| 1932658002 | Taylor Christensen Mahtook | Physician Assistant | 4650 Ambassador Caffery Pkwy Ste 101, Lafayette, LA 70508-6926 | 2016-09-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHARLOTTE B 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.