Healthcare Provider Details

I. General information

NPI: 1710564489
Provider Name (Legal Business Name): JAZMYN JORDAN SHAW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAZMYN JORDAN BRAXTON

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MEDICAL CENTER DR
NASHVILLE TN
37232-0028
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax:
Mailing address:
  • Phone: 615-322-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.149233
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number76827
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: