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General NPI Number Information
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NPI Number | 1942177415
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Entity Type | Individual
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Provider Name | JEREMY MICHAEL SHAW APRN
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Gender | Male
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 200 SW FRAZIER CIR
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City | TOPEKA
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State | KS
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Zip | 66606-2800
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Country | US
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Telephone | 785-232-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 200 SW FRAZIER CIR
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City | TOPEKA
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State | KS
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Zip | 66606-2800
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Country | US
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Telephone | 785-232-2044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-84884-021
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 53-84884-021
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License Number State | KS
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