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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TREVECCA KERRY SHAW DPM
NPI 1497917165
Podiatrist - Foot & Ankle Surgery in Louisville, KY

Active since June 25, 2008PECOS Enrolled
2406 W BROADWAY, LOUISVILLE, KY 40211(502) 775-1711(502) 443-0369 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 29, 2026, Mar 17, 2021, Jul 19, 2018 (3 updates tracked since 2018).

About Dr. Trevecca Kerry Shaw Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TREVECCA KERRY SHAW DPM (NPI 1497917165) is an individual foot & ankle surgery provider in Louisville, Kentucky, licensed in Kentucky (00338) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497917165
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameDR. TREVECCA KERRY SHAWCredential: DPM
Location Address2406 W BROADWAYLouisville, KY 40211-1008
Mailing Address1320 Belmont Ave, #1Youngstown, OH 44504-1130 · (330) 747-3910 · Fax (330) 747-3930
Phone(502) 775-1711
Fax(502) 443-0369
Sole ProprietorNo
Enumeration DateJune 25, 2008
Last NPPES UpdateSeptember 29, 20263 updates tracked since enumeration
NPPES CertifiedMarch 17, 2021
✔ NPI 1497917165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in KY · 00338
2406 W BROADWAY, Louisville, KY 40211
Open in Google Maps ↗

Other Identifiers 2

Medicaid2919864OH
Other000000614278Anthem

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Trevecca Kerry Shaw Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Trevecca Shaw reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pmr Ky Holding, LLC
909 mi
Specialist
1395 NW 167TH ST
Miami Gardens, FL 33169
  • Reassigned Medicare billing, Kentucky enrollment
  • 45 clinicians in this Medicare group
NPI 1740737709 (305) 831-4760

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MIASHA RENEE CRUTCHFIELD APRN
Nurse Practitioner (Family)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211
HEATHER A. CRANE FNP
Nurse Practitioner (Family)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211
LUCRETIA DAVIS
Nurse Practitioner (Family)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211
HERSHEMA BURNETT APRN
Nurse Practitioner (Family)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 883-6800
DR. PREETI WADHWA M.D.
Family Medicine
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211
JENCARE NEIGHBORHOOD MEDICAL CENTER WEST BROADWAY, LLC
Specialist
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (305) 653-1770
VERA TATE M.D.
Psychiatry & Neurology (Psychiatry)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211
DR. JOY LYNETTE LINDSEY AGACNP-DNP-BC
Nurse Practitioner (Acute Care)
2406 W BROADWAY
LOUISVILLE, KY 40211
Jefferson County (502) 775-1211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trevecca Shaw's NPI number?

The NPI number for Trevecca Shaw is 1497917165. It was assigned to this individual provider in the NPPES registry on June 25, 2008.

Where is Trevecca Shaw located?

Trevecca Shaw practices at 2406 W Broadway, Louisville, KY 40211. The listed phone number is (502) 775-1711.

What is Trevecca Shaw's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Trevecca Shaw enrolled in Medicare?

Yes. Trevecca Shaw is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Trevecca Shaw's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Trevecca Shaw reassigns Medicare benefits to Pmr Ky Holding, LLC (Miami Gardens, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Trevecca Shaw's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Trevecca Shaw was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.