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

Kristian Taylor Shaw, PA-C

Individual provider Behavior Technician · NPI 1477112381

Kristian Taylor Shaw, PA-C is a Physician Assistant in Lakewood, Ohio. Qualified in 2022, 4 years ago. Practices with Cleveland Clinic, a 6,935-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

14601 Detroit Ave
Lakewood, OH 44107-4205
Phone: (216) 237-5500
Show map & directions

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

Additional practice locations (1)

  • 828 Waterford Cut, Crystal Lake, IL 60014-8506 — (847) 306-9843

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Behavior Technician Taxonomy 106S00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1477112381
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 13, 2019
Last updated in NPPESMay 10, 2023
Certification dateJune 7, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cleveland Clinic — 6935 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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