Rose Mary Shaw, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6323 Issued in OH

Practice address

1525 Xenia Ave
Yellow Springs, OH 45387-1123

Phone

(937) 769-5019

Fax

(937) 769-5019

NPI assigned

May 8, 2007

Last updated

Dec 4, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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

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  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1043423718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 XENIA AVE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871123",
            "telephone_number": "937-769-5019",
            "fax_number": "937-769-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 XENIA AVE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871123",
            "telephone_number": "937-769-5019",
            "fax_number": "937-769-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROSE",
        "middle_name": "MARY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Sebastian Evans
• Amy Marie Selvage
• Anna Rose Semler
• Anya Senetra, MSW, LISW-S
• Melinda Sine Severtson, OTR/L
• Audrey Shirk, LSW
• Brianna Skinner, OTR/L
• Joyce Ann Smith, M.S. CCC-SLP
• Linda L. Sohner, SLP
• Erika Srbinovski

• Clinical Psychologist in Yellow Springs, OH
• Providers in Yellow Springs, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.