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

Todd Shaw

Individual provider Family Nurse Practitioner · NPI 1558923417

Todd Shaw is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2018, 8 years ago. Licensed in Indiana.

Years since qualifying
8
Licensed in
IN
In the registry since
2019
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Practice location Address checks out

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Phone: (260) 483-9081
Fax: (260) 483-9196
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71009323A (IN)

Record details

NPI number1558923417
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 1, 2019
Last updated in NPPESSeptember 17, 2019
Mailing addressPo Box 392552, Pittsburgh, PA 15251-9500

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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