EVERETT LEE SHAW (NPI# 1437444163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437444163 |
| Entity Type | Individual |
| Full Name | EVERETT LEE SHAW |
| Credential | PA-C |
| Practice Address |
517 N Main St Anna IL 62906-1668 |
| Practice Telephone | 6188334300 |
| Practice Fax Number | 6188339058 |
| Mailing Telephone | 6188334300 |
| Mailing Fax Number | 6188339058 |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2013-11-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.004037 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCCAP NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTAN | 1051123 | 01 | |
| IL | MEDICARE PTAN | 205790002 | 01 |
| Street Address |
517 N MAIN ST |
| City | ANNA |
| State | IL |
| Zip Code | 62906-1668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336129642 | Anna Home Care Services LLC | Home Health | 517 N Main St, Anna, IL 62906-1668 | 2006-01-20 |
| 1013567734 | Cassy A Coleman | Nurse Practitioner | 517 N Main St, Anna, IL 62906-1668 | 2019-09-14 |
| 1104300094 | Elizabeth Shallenberger | Nurse Practitioner | 517 N Main St, Anna, IL 62906-1668 | 2018-09-18 |
| 1477907780 | Anna Hospital Corporation | Family Medicine | 517 N Main St, Anna, IL 62906-1668 | 2016-04-22 |
| 1386064996 | Holly A Wilke | Registered Nurse | 517 N Main St, Anna, IL 62906-1668 | 2014-04-22 |
| 1215378955 | Midwest Neurosurgeons, LLC | Neurological Surgery | 517 N Main St, Anna, IL 62906-1668 | 2013-07-10 |
| 1942645411 | Russell John Kinsey | Physician Assistant | 517 N Main St, Anna, IL 62906-1668 | 2013-05-09 |
| 1770894263 | Bradley Michael Kutka | Emergency Medicine | 517 N Main St, Anna, IL 62906-1668 | 2010-06-29 |
| 1538347448 | Anna Hospital Corporation | Pharmacy | 517 N Main St, Anna, IL 62906-1668 | 2008-02-01 |
| 1700906021 | Kathy L Schierbaum | Nurse Practitioner | 517 N Main St, Anna, IL 62906-1668 | 2007-03-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265711600 | Community Integrated Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 110 Jeni Lane, Anna, IL 62906 | 2011-08-16 |
| 1508153768 | Union County Counseling Services Inc | Clinic/Center | 202 South St, Anna, IL 62906 | 2011-07-07 |
| 1326335589 | Union County Counseling Services Inc | Clinic/Center | 302 South St, Anna, IL 62906 | 2011-07-07 |
| 1063709228 | Union County Counseling Services Inc | Community Based Residential Treatment Facility, Mental Illness | 311 W Vienna St, Anna, IL 62906 | 2011-07-07 |
| 1598920928 | Steven Wayne Vincent | Dentist | 131 West Vienna Street, Anna, IL 62906 | 2008-07-24 |
| 1427236900 | Cardinal House Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 Douglas Street, Anna, IL 62906 | 2008-02-06 |
| 1992913719 | High Chiropractic Center | Chiropractor | 35 Walton Lane, Anna, IL 62906 | 2007-05-18 |
| 1023235678 | Chuck C. Bugle | Psychologist | 311 W. Spring St., Anna, IL 62906 | 2007-04-18 |
| 1922194604 | Nancy Kay Webb | Physical Therapist | 515 E Vienna Street, Suite I, Anna, IL 62906 | 2006-10-04 |
| 1144242918 | William W Mings | Psychiatry & Neurology | 204 South St, Anna, IL 62906 | 2006-07-24 |
| Find all providers in zip 62906 | ||||
| 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 |
|---|---|---|---|---|
| 1467900647 | Joseph C Flamm | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2016-09-15 |
| 1528515384 | Kassie L Jones | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2016-09-08 |
| 1083161020 | Jacob W Ribbing | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2016-09-07 |
| 1558763185 | Chelsea E Treece | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2014-09-26 |
| 1942645411 | Russell John Kinsey | Physician Assistant | 517 N Main St, Anna, IL 62906-1668 | 2013-05-09 |
| 1578814414 | Katrina L Tripp | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2012-10-01 |
| 1669612438 | Halley M Barke | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2009-03-05 |
| 1316115710 | Marcia A. Wells | Physician Assistant | 115 N Main St, Anna, IL 62906-1661 | 2008-02-19 |
| 1477673747 | Debra J Kester | Physician Assistant | 517 N Main St, Anna, IL 62906-1668 | 2007-03-30 |
| 1750365680 | Donald Owen Diemer | Physician Assistant | 513 N Main St, Anna, IL 62906-1668 | 2005-12-05 |
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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.