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

Everett Lee Shaw, PA-C

Individual provider Physician Assistant · NPI 1437444163

Everett Lee Shaw, PA-C is a Physician Assistant in Decatur, Illinois. Qualified in 2001, 25 years ago. Practices with Baptist Health Deaconess Medical Group Inc, a 240-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
25
Licensed in
IL
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4775 E Maryland St
Decatur, IL 62521-8820
Phone: (217) 864-3737
Fax: (217) 864-3468
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.004037 (IL)

Record details

NPI number1437444163
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 10, 2011
Last updated in NPPESJanuary 17, 2023
Certification dateJanuary 17, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Baptist Health Deaconess Medical Group Inc — 240 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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