Individual provider Active NPI

Jamie L Shaw, BA QMHS

  • Social Worker
  • Wooster, OH
National Provider Identifier
1003440397
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S2511816 Issued in OH
Practice address
2587 Back Orrville Rd
Wooster, OH 44691-9523
Phone
(330) 264-9597
Fax
(330) 264-0946
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S2303302TRNE OH
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X S2511816 OH Primary

Addresses

Primary practice location

2587 Back Orrville Rd
Wooster, OH 44691-9523

Mailing address

2587 Back Orrville Rd
Wooster, OH 44691-9523
Phone (330) 264-9597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
S2303302TRNEOHMDSocial Worker
S2511816OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anazao Community Partners PastSince Mar 1, 2020 Accepting new patients
Anazao Community Partners PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1003440397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 BACK ORRVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919523",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2587 BACK ORRVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919523",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JAMIE",
        "middle_name": "L",
        "credential": "BA QMHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S2303302TRNE",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S2511816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.