Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Tavis M. Shaw, DO

Individual provider Urology Physician · NPI 1871662809

Dr. Tavis M. Shaw, DO is an Urology in Wpafb, Ohio. Graduated from Kansas City University of Med & Biosciences, College of Osteo Med in 2003, 23 years ago. Practices with Alaska Native Tribal Health Consortium, a 603-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Ohio, Pennsylvania and Utah.

Years since qualifying
23
Trained at
Kansas City University of Med & Biosciences, College of Osteo Med
Licensed in
OH, PA, UT
In the registry since
2006
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone: (937) 257-9292
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5171 S Cottonwood St Ste 210, Murray, UT 84107-5718 — (801) 507-3380

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 14235720-1204 (UT)
Urology Physician Taxonomy 208800000X · Licence OS013233 (PA)
Urology Physician Taxonomy 208800000X · Licence 34.009996 (OH)
Surgery Physician Taxonomy 208600000X · Licence OS013233 (PA)

Record details

NPI number1871662809
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedNovember 6, 2006
Last updated in NPPESMay 20, 2026
Certification dateMay 20, 2026
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolKANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated 2003 (23 years in practice)
Group practice Alaska Native Tribal Health Consortium — 603 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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