Tonya Shaw, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

866136 Issued in MS

Practice address

4560 Methodist Home Rd
Jackson, MS 39213-4201

Phone

(601) 927-0188

Fax

(601) 292-7998

NPI assigned

Oct 20, 2021

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1043973506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2305",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390602305",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 METHODIST HOME RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134201",
            "telephone_number": "601-927-0188",
            "fax_number": "601-292-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5345 Highway 18 W",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392099421",
            "country_code": "US",
            "telephone_number": "601-926-1988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TONYA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "866136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02551264",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://urbanrehabinc.account.box.com/login",
            "affiliation": "N",
            "endpointDescription": "hippa secure data box",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "5345 Highway 18 W",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392099421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://urbanrehabinc.account.box.com/login",
            "affiliation": "N",
            "endpointDescription": "hippa secure data box",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "4560 Methodist Home Rd",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392134201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lynn Carol Sharp, APRN
• Patricia Jean Sharp, FNP-BC
• Samuel Andrew Sharp, FNP-BC
• John Shaughnessy III
• Glenn D Shaw, R.PH.
• Christian Brooks Shearer, LPC
• Victoria Bass Shearer, D.C.
• John Joseph Sheehan Jr., M.D.
• Natale Tate Sheehan, MD
• Thomas Sheffield Sr., M. D.

• Registered Nurse in Jackson, MS
• Providers in Jackson, MS by specialty
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.