DR. VANCE CLEVELAND SHAW (NPI# 1518978402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518978402 |
| Entity Type | Individual |
| Full Name | DR. VANCE CLEVELAND SHAW |
| Credential | M.D. |
| Practice Address |
205 High Point Dr Johnson City TN 37601-1503 |
| Practice Telephone | 4236310731 |
| Practice Fax Number | 4236310732 |
| Mailing Telephone | 4236310731 |
| Mailing Fax Number | 4236310732 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2015-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD20911 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TAX ID | 300121608 | 01 |
| Street Address |
205 HIGH POINT DR |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093169443 | Evidence Based Addiction Medicine | Clinic/Center | 205 High Point Dr, Johnson City, TN 37601-1503 | 2016-04-21 |
| 1134506744 | Jennifer Lee | Counselor | 205 High Point Dr, Johnson City, TN 37601-1503 | 2015-05-04 |
| 1154697563 | Elli Bonnett Saraceno | Internal Medicine | 205 High Point Dr, Johnson City, TN 37601-1503 | 2012-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154775468 | Luke Spencer | Family Medicine | 917 W. Walnut Street, Johnson City Family Medicine Center, Johnson City, TN 37604 | 2016-04-22 |
| 1184043853 | Shivali M Patel | Family Medicine | 400 N State of Franklin Rd Fl 4, Johnson City, TN 37604-6035 | 2014-04-10 |
| 1306062542 | Debra J. Uncapher | Family Medicine | 1409 W Market St Ste 108, Johnson City, TN 37604-6005 | 2007-04-17 |
| 1609947944 | Daniela Pogan Wright | Family Medicine | 401 East Main Strette, Johnson City, TN 37601-4877 | 2006-11-10 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1063459410 | State of Franklin Healthcare Associates Pllc | Family Medicine | 2528 Wesley St, Suite 2, Johnson City, TN 37601-1724 | 2006-06-01 |
| 1316995491 | Robert Elsworth Grindstaff | Family Medicine | 2203 Mckinley Rd, Ste 107, Johnson City, TN 37604-6893 | 2006-05-04 |
| 1184680787 | Paul E Moran IIi | Family Medicine | 1321 Sunset Dr, Suite 22, Johnson City, TN 37604-3698 | 2006-04-22 |
| 1295799120 | Guy W Robins | Family Medicine | 101 Med Tech Pkwy Ste 100, Johnson City, TN 37604-4006 | 2006-04-17 |
| 1285603985 | Krish Purswani | Family Medicine | 119 E King St, Suite 208, Johnson City, TN 37601-4721 | 2006-03-15 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
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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.