Shaw Living PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHAW LIVING PC

Practice address

2484 E Pinetree Blvd
Thomasville, GA 31792-4854

Phone

(229) 226-8800

Fax

(229) 226-8232

NPI assigned

Jun 13, 2019

Last updated

Feb 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lacy Bradford

Title

Office Manager

Phone

(229) 594-6800

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa S Carr, CNP

  • Nurse Practitioner
  • Thomasville, GA
  • NPI 1073568630
  Medicare reassignment NPD
• Martha Hanna, NP

  • Family Nurse Practitioner
  • Thomasville, GA
  • NPI 1790178564
  Medicare reassignment NPD
• Sabra Elizabeth Lowe, L.D.

  • Registered Dietitian
  • Thomasville, GA
  • NPI 1770517336
  Medicare reassignment NPD
• Brenda W. McCurdy, AGNP-C

  • Adult Health Nurse Practitioner
  • Cordele, GA
  • NPI 1083015531
  Medicare reassignment NPD
• Elizabeth A Nicholson, LCSW

  • Clinical Social Worker
  • Thomasville, GA
  • NPI 1245558964
  Medicare reassignment NPD
• Brandi Weaver Warren, DO

  • Family Medicine Physician
  • Thomasville, GA
  • NPI 1417046517
  Medicare reassignment NPD

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1033778923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 E PINETREE BLVD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924854",
            "telephone_number": "229-594-6800",
            "fax_number": "833-464-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 E PINETREE BLVD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924854",
            "telephone_number": "229-226-8800",
            "fax_number": "229-226-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW LIVING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "LACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-594-6800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179012663G",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandi.warren.1@27346.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2484 E Pinetree Blvd",
            "city": "Thomasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317924854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darren Logan Seymour, PT, DPT
• Asif Rashid Shah, MBBS
• Shalom Counseling Services, LLC
• Jameisha Shavers, PHARMD
• Shaw Center for Women's Health
• Ansley Shaw, M.ED., CCC-SLP
• She Shall Not Fail Doula Services, LLC
• Tracy L. Shelby, PH.D.
• Donna Baker Sherman
• Sheryl Avon Skipper

• Family Medicine Physician in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.